OrganizationActive
Jerry L. Pettis Va Memorial Hospital
NPI 1629264775 · Psychiatric Hospital · Riverside, CA
Jerry L. Pettis Va Memorial Hospital is a Psychiatric Hospital organization in Riverside, CA (NPI 1629264775).
Provider details
- NPI number
- 1629264775
- Entity type
- Organization
- Primary specialty
- Psychiatric HospitalHospitals
- Organization subpart
- No
- Authorized official
- Dean Stordahl, Ceo(909) 825-7084
- License
- 219193 (CA)
Specialties & taxonomies
Hospitals
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
19845 San Luis Rey Ln
Riverside, CA 92508-6494
Phone: (951) 653-7051
Street-level locationGet directions
Mailing address
19845 San Luis Rey Ln
Riverside, CA 92508-6494
Registry dates
- Enumerated
- 2007-09-22
- Last updated
- 2007-09-22
Frequently asked questions
- What is Jerry L. Pettis Va Memorial Hospital's NPI number?
- Jerry L. Pettis Va Memorial Hospital's National Provider Identifier (NPI) is 1629264775, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jerry L. Pettis Va Memorial Hospital?
- Jerry L. Pettis Va Memorial Hospital is classified in the NPPES registry as Psychiatric Hospital (Hospitals).
- Where is Jerry L. Pettis Va Memorial Hospital located?
- Jerry L. Pettis Va Memorial Hospital's practice location on file with NPPES is 19845 San Luis Rey Ln, Riverside, CA 92508-6494.
- What is Jerry L. Pettis Va Memorial Hospital's phone number?
- The practice phone number listed in the NPPES registry for Jerry L. Pettis Va Memorial Hospital is (951) 653-7051.
- Who is the authorized official for Jerry L. Pettis Va Memorial Hospital?
- The authorized official listed on Jerry L. Pettis Va Memorial Hospital's NPPES record is Dean Stordahl, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jerry L. Pettis Va Memorial Hospital's NPI active?
- Yes — Jerry L. Pettis Va Memorial Hospital's NPI (1629264775) is active in the NPPES registry as of the last update on 2007-09-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.