Individual provider Active NPI

Elizabeth Cristina Maciel, LCSW

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1144834631
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
135160 Issued in CA
Practice address
876 N Mountain Ave
Upland, CA 91786-4156
Phone
(657) 246-2716
NPI assigned
Sep 2, 2020
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Clinical Social Worker 1041C0700X 135160 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 102545 CA

Addresses

Primary practice location

876 N Mountain Ave
Upland, CA 91786-4156

Mailing address

876 N Mountain Ave Ste 200P
Upland, CA 91786-4166
Phone (657) 246-2716

Other practice location 1

1401 S Harbor Blvd Apt 8
LA Habra, CA 90631-7556
Phone (702) 418-8395

Other practice location 2

2008 N Garey Ave
Pomona, CA 91767-2722
Phone (909) 623-6131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251124003816 CA Practitioner - Clinical Social Worker 1850883158 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102545CAMDClinical Social Worker
135160CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Talk Therapy Center Clinical CurrentSince Nov 10, 2025 Accepting new patients
Tri-City Mental Health Authority CurrentSince Oct 11, 2020 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Jan 1, 2026 Accepting new patients
Tri-City Mental Health Center PastSince Oct 11, 2020 Accepting new patients

Locations

2008 N Garey Ave
Pomona, CA 91767
Phone (909) 242-7640

19322 Jesse Ln
Riverside, CA 92508
Phone (951) 387-4040

19322 Jesse Ln
Ste 200
Riverside, CA 92508
Phone (951) 387-4040

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1144834631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 N MOUNTAIN AVE STE 200P",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864166",
            "telephone_number": "657-246-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864156",
            "telephone_number": "657-246-2716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 S Harbor Blvd Apt 8",
            "address_purpose": "LOCATION",
            "city": "LA Habra",
            "state": "CA",
            "postal_code": "906317556",
            "country_code": "US",
            "telephone_number": "702-418-8395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2008 N Garey Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917672722",
            "country_code": "US",
            "telephone_number": "909-623-6131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACIEL",
        "first_name": "ELIZABETH",
        "middle_name": "CRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "135160",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "102545",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.