Bianca Rebolledo, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A157704 Issued in CA

Practice address

11234 Anderson St
Loma Linda University Health Psychiatry
Loma Linda, CA 92354-2804

Phone

(909) 558-9532

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdiaz81239@direct.llu.edu

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.

• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Medical Toxicology (Emergency Medicine) Physician
  • San Bernardino, CA
  • NPI 1487124798
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1649547944
  NPD

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1396277703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LOMA LINDA UNIVERSITY HEALTH PSYCHIATRY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOLLEDO",
        "first_name": "BIANCA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A157704",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A157704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anwar S Raza, M.D.
• Asma Razavi, M.D.
• Anees J Razzouk, M.D.
• Brenda Lynn Rea, MD
• Aleksander Real
• Matthew Reddoch
• Neha M Reddy
• Eryn Elisabeth Reeder
• Mark Reeves, M.D.
• Matthew Edward Reeves

• Child & Adolescent Psychiatry Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.