Active NPI
Maria Patricia Gallegos, M.S
- Professional Counselor
- San Bernardino, CA
National Provider Identifier
1003178484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7731
- Practice address
- 1908 Business Center Dr
Suite 220
San Bernardino, CA 92408-3436 - Phone
- (909) 890-5930
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 7258 | CA | |
| Mental Health Counselor | 101YM0800X | 522 | CA | |
| Professional Counselor | 101YP2500X | 7731 | CA | Primary |
Addresses
Primary practice location
1908 Business Center Dr
Suite 220
San Bernardino, CA 92408-3436
Mailing address
1908 Business Center Dr
Suite 220
San Bernardino, CA 92408-3436
Phone (909) 890-5930
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7258 | CA | MD | Mental Health Counselor |
| 7731 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soultenders, Inc. | Mental Health | Current | Accepting new patients |
Locations
41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249
10532 Acacia St
Ste B4
Rch Cucamonga, CA 91730
Phone (909) 325-3766
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1003178484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1908 BUSINESS CENTER DR",
"address_2": "SUITE 220",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083436",
"telephone_number": "909-890-5930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1908 BUSINESS CENTER DR",
"address_2": "SUITE 220",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083436",
"telephone_number": "909-890-5930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLEGOS",
"first_name": "MARIA",
"middle_name": "PATRICIA",
"credential": "M.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "7258",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "522",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "7731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.