Elizabeth Carbajal Gallegos, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

303230 Issued in CA

Practice address

69175 Ramon Rd
Building a
Cathedral City, CA 92234-3344

Phone

(619) 344-2819

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: egallegos218377@direct.ochin.org

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.

• Dap Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Palm Springs, CA
  • NPI 1306464326
  Medicare reassignment NPD
• Impression Healthcare Services, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Grand Terrace, CA
  • NPI 1487885497
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1730119793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 LA VERNE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736015",
            "telephone_number": "909-792-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69175 RAMON RD",
            "address_2": "BUILDING A",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343344",
            "telephone_number": "619-344-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "ELIZABETH",
        "middle_name": "CARBAJAL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "303230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loretta Soledad Flores, ED.S.
• Renata Gabrielle Flores I
• Four Lions Dental Corporation
• Robyn L Fuller, PA-C
• Valerie Fury
• Leonard Merlin Galloway, MPT
• Andrea Gaona
• Leandro R Garcia Gallegos
• Garden Living at Alpine LLC
• Garfield Beach CVS LLC

• Psychiatric/Mental Health Nurse Practitioner in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.