Melanin Youth Foundation

Specialty details in registry · Perris, CA

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At a glance

21550 Lane St, Perris, CA 92570-8140

NPPES record updated Sep 16, 2025. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

21550 Lane St
Perris, CA 92570-8140

Additional reported practice locations

1300 Mount Diablo St Ste F3
Perris, CA 925701824
Phone: 9517125031
Professional details: NPI, taxonomy & registry record
NPI1124999214
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
251V00000X
Enumeration date
Sep 13, 2025
Record updated
Sep 16, 2025
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

171M00000X

Specialty details in registry

172V00000X

Specialty details in registry

174H00000X

Specialty details in registry

251S00000X

Specialty details in registry

251V00000X · Primary

Specialty details in registry

374J00000X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

21550 Lane St
Perris, CA 92570-8140
Phone
(951) 712-5031
Mailing address
19510 VAN BUREN BLVD.
STE F3 PMB 152
RIVERSIDE, CA 925089458
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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