Individual provider Active NPI

Laura Jill Herzberg, M.D.

  • Pediatrics Physician
  • Santa Maria, CA
National Provider Identifier
1801989371
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A76085 Issued in CA
Practice address
2801 Santa Maria Way
Santa Maria, CA 93455-2118
Phone
(805) 934-5400
Fax
(805) 938-9207
NPI assigned
Oct 2, 2006
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A76085 CA Primary

Addresses

Primary practice location

2801 Santa Maria Way
Santa Maria, CA 93455-2118

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8017

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071217000847 CA Practitioner - Pediatric Medicine 2062502875 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A76085CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 10, 2011 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 10, 2011 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients

Locations

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

416 Spring St
Ste A
Paso Robles, CA 93446

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

2801 Santa Maria Way
Santa Maria, CA 93455
Phone (805) 934-5400

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

Interoperability endpoints

  • Direct secure messaging: laura.herzberg.1@17363.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1801989371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8017",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 SANTA MARIA WAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934552118",
            "telephone_number": "805-934-5400",
            "fax_number": "805-938-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERG",
        "first_name": "LAURA",
        "middle_name": "JILL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A76085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.