MEDICARE: COUNTY OF RIVERSIDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	00033	CA
2	2084P0800X	Psychiatry Physician		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316017825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF RIVERSIDE

Provider Business Mailing Address
First Line	:	PO BOX 7549
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92513-7549
Country	:	US
Telephone Number	:	951-358-6900
Fax Number	:	951-358-6905

Provider Business Practice Location Address
First Line	:	4095 COUNTY CIRCLE DR
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-3410
Country	:	US
Telephone Number	:	951-358-4613
Fax Number	:	951-358-6868

Authorized Official
Title or Position	:	DIRECTOR DEPT OF MENTAL HEALTH
Name	:	MR. JERRY A WENGERD
Credential	:
Telephone Number	:	951-358-4500

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	05/16/2008

Similar Medicare Providers

1629910559 — MIA ROMERO BS-PH
Practice Location Address:

4065 COUNTY CIRCLE DR
RIVERSIDE, CA
92503-3410

Practice Phone: 951-470-5282
Practice Fax:

1053253997 — ANDREW MICHAEL WALLIN
Practice Location Address:

4065 COUNTY CIRCLE DR
RIVERSIDE, CA
92503-3410

Practice Phone: 951-892-9873
Practice Fax:

1447261540 — COUNTY OF RIVERSIDE
Practice Location Address:

4095 COUNTY CIRCLE DR
RIVERSIDE, CA
92503-3410

Practice Phone: 951-358-4501
Practice Fax: 951-358-6905

1952496010 — COUNTY OF RIVERSIDE
Practice Location Address:

4065 COUNTY CIRCLE DR
RIVERSIDE, CA
92503-3410

Practice Phone: 951-358-5070
Practice Fax: 951-358-5015

1033289806 — COUNTY OF RIVERSIDE
Practice Location Address:

4095 COUNTY CIRCLE DR
RIVERSIDE, CA
92503-3410

Practice Phone: 951-358-4613
Practice Fax: 951-358-6868

1902978380 — COUNTY OF RIVERSIDE
Practice Location Address:

4095 COUNTY CIRCLE DR
RIVERSIDE, CA
92503-3410

Practice Phone: 951-358-4613
Practice Fax: 951-358-6868

Directions to “COUNTY OF RIVERSIDE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.