# LLPMG APPLE VALLEY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114840816
- **Authorized official:** LIBERTY OLIVE MACIAS NP (CEO)
- **Authorized official phone:** (909) 900-6465

## Contact information

- **Practice address:** 18522 US HIGHWAY 18 STE 206, APPLE VALLEY, CA 92307-2321
- **Practice address phone:** (760) 946-4664
- **Mailing address:** PO BOX 1303, LOMA LINDA, CA 92354-1303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2026
- **Last updated:** 07/31/2026