Active NPI
Tammy Sue Elmblad
- Addiction (Substance Use Disorder) Counselor
- Upland, CA
National Provider Identifier
1114657459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1469300522
- Practice address
- 1260 E Arrow Hwy
Upland, CA 91786-4982 - Phone
- (909) 932-1069
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1469300522 | CA | Primary |
Addresses
Primary practice location
1260 E Arrow Hwy
Upland, CA 91786-4982
Mailing address
1260 E Arrow Hwy
Upland, CA 91786-4982
Phone (909) 932-1069
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1469300522 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1114657459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 E ARROW HWY",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864982",
"telephone_number": "909-932-1069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 E ARROW HWY",
"city": "UPLAND",
"state": "CA",
"postal_code": "917864982",
"telephone_number": "909-932-1069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMBLAD",
"first_name": "TAMMY",
"middle_name": "SUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1469300522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
- Elite Compassionate Services of Ca, LLC
- Elite Interpreting Services
- Elite Medical Group GP
- Ellee Residential Care 4 LLC
- Anthony Jerome Ellis, C.P.
- Elsa Matsumoto Licensed Clinical Social Worker Inc.
- Emerald Gardens Hospice, Inc.
- Emerge Industries LLC
- Eminence Health Management Inc.
- Empire Foot and Ankle Center Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.