Mayra Andrea Rosel-Bucio

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

106071 Issued in CA

Practice address

4411 E Kings Canyon Rd
Fresno, CA 93702-3604

Phone

(559) 623-0900

NPI assigned

May 4, 2012

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• JDT Consultants

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1437289881
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1013276443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-623-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-623-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W Shaw Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113307",
            "country_code": "US",
            "telephone_number": "559-221-1680",
            "fax_number": "559-221-4336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEL-BUCIO",
        "first_name": "MAYRA",
        "middle_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "171924",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "106071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bruce Rose, PH.D.
• Jolene Marie Rose, PHARMD
• Kaitlyn Elizabeth Rose
• Madisyn Rae Rose
• Rachel Helene Rose, MD
• Amanda Noelle Rosen
• Eric Morris Rosen, LMFT 97204
• Nicole Samila Rosendo, PA-C
• Jeffrey Rosenfeld, MD
• Shawn Rosenlof, PSY.D.

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.