Organization Active NPI

Llpmg Redlands

  • Psychiatric/Mental Health Nurse Practitioner
  • Redlands, CA
National Provider Identifier
1215850904
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LLPMG REDLANDS
Practice address
1200 California St Ste 140
Redlands, CA 92374-2946
Phone
(909) 792-6262
Fax
(909) 550-1928
NPI assigned
Jul 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Liberty Olive Macias, NP
Title
Ceo
Phone
(909) 900-6465

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1200 California St Ste 140
Redlands, CA 92374-2946

Mailing address

1200 California St Ste 140
Redlands, CA 92374-2946
Phone (909) 792-6262

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1215850904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CALIFORNIA ST STE 140",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742946",
            "telephone_number": "909-792-6262",
            "fax_number": "909-550-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CALIFORNIA ST STE 140",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742946",
            "telephone_number": "909-792-6262",
            "fax_number": "909-550-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLPMG REDLANDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "MACIAS",
        "authorized_official_first_name": "LIBERTY",
        "authorized_official_middle_name": "OLIVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-900-6465",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.