RADIANCE KETAMINE CLINIC – NPI #1912543968
Psychiatry & Neurology

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

RADIANCE KETAMINE CLINIC is a psychiatry & neurologist located in RENO, NV. NPPES has assigned the NPI number 1912543968 to RADIANCE KETAMINE CLINIC on November 25, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “RADIANCE KETAMINE CLINIC” is a dba name, the actual legal business name for this organization is PRIDE MEDICAL SPA AND WELLNESS CENTER INC. The primary taxonomy selected by this provider is 2084P0800X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Psychiatry

The NPI profile was previously updated about 6 years ago on Aug 27, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for RADIANCE KETAMINE CLINIC below.

NPI Profile for
PRIDE MEDICAL SPA AND WELLNESS CENTER INC

NPI Number
1912543968
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRIDE MEDICAL SPA AND WELLNESS CENTER INC
Doing Business As (dba): RADIANCE KETAMINE CLINIC
Primary location
5365 MAE ANNE AVE STE A10
RENO, NV 89523-1841
Phone: (775) 432-1500 Fax: (775) 432-1002
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
GREG JONES
CLINIC DIRECTOR
Phone: (775) 217-0332
Updated
Certification Date
Aug 27, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084P0800X
- Psychiatry & Neurology / Psychiatry (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.