Individual provider Active NPI

Elizabeth Robledo, DACM, L.AC

  • Acupuncturist
  • San Bernardino, CA
National Provider Identifier
1023575248
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
18345 Issued in CA
Practice address
275 W Hospitality LN Ste 100
San Bernardino, CA 92408-3238
Phone
(909) 567-2221
Fax
(909) 763-3216
NPI assigned
Feb 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 18345 CA Primary

Addresses

Primary practice location

275 W Hospitality LN Ste 100
San Bernardino, CA 92408-3238

Mailing address

24395 Lamont Dr
Moreno Valley, CA 92553-3580
Phone (951) 287-6431

Other identifiers 2

IdentifierTypeStateIssuer
815006275MedicaidCA
815006275OtherCATRANSIT PHYSICAL THERAPY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18345CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transit Physical Therapy PC PastSince Jul 25, 2024 Accepting new patients
Redlands Spine and Sport Single Specialty PastSince Oct 8, 2012 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1023575248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24395 LAMONT DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533580",
            "telephone_number": "951-287-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083238",
            "telephone_number": "909-567-2221",
            "fax_number": "909-763-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLEDO",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DACM, L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-24",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "18345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "815006275",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRANSIT PHYSICAL THERAPY",
            "identifier": "815006275",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.