Individual provider Active NPI

Teresa Frausto, M.D.

  • Psychiatry Physician
  • Loma Linda, CA
National Provider Identifier
1992737068
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G75172 Issued in CA
Practice address
11374 Mountain View Ave
Suite a
Loma Linda, CA 92354-3830
Phone
(909) 558-4505
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G75172 CA Primary

Addresses

Primary practice location

11374 Mountain View Ave
Suite a
Loma Linda, CA 92354-3830

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00G751720MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75172CAMDDental Assistant
G75172CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
County of San Bernardino CurrentSince May 17, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2024 Accepting new patients
County of San Bernardino Current Accepting new patients
County of San Bernardino CurrentSince May 17, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients

Locations

17053 Foothill Blvd
Bldg B
Fontana, CA 92335
Phone (909) 347-1300

11374 Mountain View Ave
Ste A
Loma Linda, CA 92354
Phone (909) 478-0078

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

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

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

850 E Foothill Blvd
Rialto, CA 92376
Phone (909) 421-9200

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

820 E Gilbert St
Sn Bernrdno, CA 92415

12625 Hesperia Rd
Victorville, CA 92395
Phone (760) 955-1777

Interoperability endpoints

  • Direct secure messaging: tfrausto6955@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, 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992737068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11374 MOUNTAIN VIEW AVE",
            "address_2": "SUITE A",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543830",
            "telephone_number": "909-558-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAUSTO",
        "first_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G75172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G751720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.