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General NPI Number Information
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NPI Number | 1124928817
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Entity Type | Organization
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Legal Business Name | INLAND PSYCHIATRIC MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 17383 W SUNSET BLVD STE A250
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-4181
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Country | US
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Telephone | 424-216-9222
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Fax | 424-538-4319
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Provider Business Mailing Address
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Address Line | 1809 W REDLANDS BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-8054
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Country | US
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Telephone | 909-289-4075
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Fax | 909-363-8233
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Authorized Official
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Title or Position | PROVIDER RELATIONS ADMIN
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Name | AMBER GUTIERREZ
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Credential |
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Telephone | 909-289-4075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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