Individual provider Active NPI

Maria Patricia Gallegos, M.S

  • Professional Counselor
  • San Bernardino, CA
National Provider Identifier
1003178484
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7731 Issued in CA
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

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250617001533 CA Practitioner - Mental Health Counselor 2961913975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7258CAMDMental Health Counselor
7731CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. Mental Health CurrentSince Mar 31, 2025 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

Verify at the official NPI Registry.