Unknown Individual – Child & Adolescent Psychiatry Physician, NPI 1669577896
Child & Adolescent Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
400 N MOUNTAIN AVE STE 244
UPLAND, CA 917865177
Phone: (909) 946-0707
Fax: (909) 946-1946
Type: Mailing
400 N Mountain Ave Ste 244
Upland, CA 917865177
Phone: (909) 946-0707
Fax: (909) 946-1946
Type: Location
4441 E KINGS CANYON RD
FRESNO, CA 937023604
Phone: (678) 359-3138
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $296.
Total Amount is formed as General ($296) + Research ($0) + Ownership ($0) = $296.
Last reported payment date: 2023-11-09 • Largest payer in this snapshot: ITI, Inc. ($116).
Total Amount
$296
General + Research + Ownership
Payments
16
Total payment records
General Amount
$296
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. | $116 |
| Ironshore Pharmaceuticals Inc. | $76 |
| Supernus Pharmaceuticals, Inc. | $58 |
| Teva Pharmaceuticals USA, Inc. | $46 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91786)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| P S Y C H I A T R Y | CA | |
| Marriage And Family Therapist | CA | |
| P S Y C H I A T R Y | CA | |
| Marriage And Family Therapist | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| - | CA |
Reviews
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