Individual provider Active NPI

Veriah Briselle Plasencia, MD

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1255891917
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A176403 Issued in CA
Practice address
11175 Campus St
Loma Linda, CA 92350-2568
Phone
(909) 558-2840
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X U1355 TX
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Pediatrics Physician 208000000X A176403 CA Primary

Addresses

Primary practice location

11175 Campus St
Loma Linda, CA 92350-2568

Mailing address

11175 Campus St RM A1111
Loma Linda, CA 92350-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GU2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240612002574 CA Practitioner - Pediatric Medicine 6507308905 Reassigns benefits to 2 organizations
I20260225002393 GU Practitioner - Pediatric Medicine 6507308905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

388 Ypao Rd
Tamuning, GU 96913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A176403CAMDPediatrics Physician
U1355TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 16, 2024 Accepting new patients
General Conference Corp of Sda Single Specialty CurrentSince Feb 2, 2026 Accepting new patients
Sac Health System Single Specialty Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Sac Health System CurrentSince Jul 15, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Sac Health System CurrentSince Jul 15, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: vplasencia1195260@direct.llu.edu

Organizations & group practices 9

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1255891917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST RM A1111",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923502568",
            "telephone_number": "909-558-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLASENCIA",
        "first_name": "VERIAH",
        "middle_name": "BRISELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U1355",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A176403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.