Elizabeth Preston Cisneros, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY 24603 Issued in CA

Practice address

255 E Bonita Ave Dept of
Pomona, CA 91767-1933

Phone

(909) 596-7733

NPI assigned

May 27, 2009

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Preston Former name

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colina Medical Associates, Inc.Group PAC ID 1759511165, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: casacolina@direct.casacolina.org
• Direct secure messaging: clinic.casacolina@direct.casacolina.org

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.

• Colina Medical Associates, Inc.

  • Clinical Neuropsychologist
  • Pomona, CA
  • NPI 1710321856
  Medicare reassignment Care Compare group NPD
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  NPD
• Seal Beach Physical Therapy Inc.

  • Physical Therapist
  • Seal Beach, CA
  • NPI 1316262983
  NPD (past)
• Xcelerate Physical Therapy Inc.

  • Physical Therapist
  • Thousand Oaks, CA
  • NPI 1306814124
  NPD (past)

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1619102100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14788 OAK LEAF DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928801048",
            "telephone_number": "909-573-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE DEPT OF",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671933",
            "telephone_number": "909-596-7733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14788 Oak Leaf Dr",
            "address_purpose": "LOCATION",
            "city": "Eastvale",
            "state": "CA",
            "postal_code": "928801048",
            "country_code": "US",
            "telephone_number": "909-573-6415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "ELIZABETH",
        "middle_name": "PRESTON",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 24603",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 24603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PRESTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gloria Ha Phuoc Chung, D.O.
• Ida Chung, O.D.
• Timothy Han Chuong
• Ashley Cichon
• Joel Anfone Cipres, PHYSICAL THERAPIST
• Irvin Cisneros
• Isabella Cisneros
• Ivette Cisneros
• William Joseph Clabaugh, SUDCC#7266
• Claremont Community Care Clinic

• Clinical Neuropsychologist in Pomona, CA
• Providers in Pomona, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.