| Dogon Behavioral Medical Group And Dogon Psychiatric Services | |
|
4960 Arlington Ave Suite B Riverside CA 92504-2738 | |
| (951) 341-8930 | |
| (951) 341-8932 |
| Full Name | Dogon Behavioral Medical Group And Dogon Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4960 Arlington Ave, Riverside, California |
| Authorized Official Name and Position | Samuel Dey (ADMINISTRATOR) |
| Authorized Official Contact | 9513418935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dogon Behavioral Medical Group And Dogon Psychiatric Services Po Box 5109 Riverside CA 92517-5109 Ph: (951) 341-8935 | Dogon Behavioral Medical Group And Dogon Psychiatric Services 4960 Arlington Ave Suite B Riverside CA 92504-2738 Ph: (951) 341-8930 |
| NPI Number | 1184782583 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 8325075310 |
|---|---|
| Medicare Enrollment ID | O20050721000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184782583 | NPI | - | NPPES |
| 33GHAI | Other | CA | COUNTY SPECIALIST ID |
| 7078316 | Other | CA | AETNA |
| DE8880 | Other | CA | PALMETTO GBA |
| 33GH00 | Other | CA | COUNTY SPECIALIST ID |
| ZZZ16441 | Other | CA | TRIWEST |
| ZZZ65471Z | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G549970 (California) | Primary |
| Provider Name | Samuel Dey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447271242 PECOS PAC ID: 0143200485 Enrollment ID: I20040726000743 |
| Provider Name | Mavernie V Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952318446 PECOS PAC ID: 6800839911 Enrollment ID: I20050608000982 |
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