MEDICARE: REGENERATION PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1285200584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENERATION PSYCHIATRY

Provider Business Mailing Address
First Line	:	2512 ARTESIA BLVD STE 320
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3282
Country	:	US
Telephone Number	:	424-277-2899
Fax Number	:	424-277-2899

Provider Business Practice Location Address
First Line	:	2512 ARTESIA BLVD STE 320
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3282
Country	:	US
Telephone Number	:	424-277-2899
Fax Number	:	424-277-2899

Authorized Official
Title or Position	:	COO
Name	:	JOBERT BALLESTEROS POBLETE
Credential	:	MD
Telephone Number	:	424-277-2821

Provider Enumeration Date	:	05/28/2021
Last Update Date	:	04/23/2025

Similar Medicare Providers

1861933103 — WENQI FENG
Practice Location Address:

2512 ARTESIA BLVD STE 320
REDONDO BEACH, CA
90278-3282

Practice Phone: 424-277-2899
Practice Fax:

1861949422 — PATRICIA OBIAGELIAKU EKWUEME MD, MPH
Practice Location Address:

2512 ARTESIA BLVD STE 320
REDONDO BEACH, CA
90278-3282

Practice Phone: 424-277-2899
Practice Fax:

1770045304 — REBECCA TALKIN SALAMO MD
Practice Location Address:

2512 ARTESIA BLVD STE 320
REDONDO BEACH, CA
90278-3282

Practice Phone: 424-277-2899
Practice Fax:

1467283614 — REBECCA SALAMO MD INC
Practice Location Address:

2512 ARTESIA BLVD STE 320
REDONDO BEACH, CA
90278-3282

Practice Phone: 424-277-2899
Practice Fax:

1881675239 — ATLANTIC KIDNEY CENTERS INC
Practice Location Address:

4700 N CONGRESS AVE , STE 104
WEST PALM BEACH, FL
33407-3282

Practice Phone: 561-845-2888
Practice Fax: 561-845-7282

1891705919 — AMY ANN GARCIA P.A.-C
Practice Location Address:

4700 N CONGRESS AVE , SUITE 100
WEST PALM BEACH, FL
33407-3282

Practice Phone: 561-845-7770
Practice Fax: 561-842-2988

Directions to “REGENERATION PSYCHIATRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.