Provider Demographics
NPI:1447142732
Name:INSIDE OUT PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:INSIDE OUT PSYCHIATRY, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-BC
Authorized Official - Phone:213-808-4940
Mailing Address - Street 1:11317 FITZPATRICK DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8314
Mailing Address - Country:US
Mailing Address - Phone:213-808-4940
Mailing Address - Fax:
Practice Address - Street 1:11317 FITZPATRICK DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8314
Practice Address - Country:US
Practice Address - Phone:213-808-4940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-19
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1982393716Medicaid