Individual provider Active NPI

Mia Stephanie Crofton

  • Health & Wellness Coach
  • San Jacinto, CA
National Provider Identifier
1245143130
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
2B58B11135 Issued in CA
Practice address
1050 N Ramona Blvd
San Jacinto, CA 92582-2552
Phone
(951) 929-7700
NPI assigned
Sep 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X 2B58B11135 CA Primary

Addresses

Primary practice location

1050 N Ramona Blvd
San Jacinto, CA 92582-2552

Mailing address

13608 Baxter CT
Moreno Valley, CA 92555-6026

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1245143130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13608 BAXTER CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925556026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N RAMONA BLVD",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925822552",
            "telephone_number": "951-929-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFTON",
        "first_name": "MIA",
        "middle_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "2B58B11135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.