Individual provider Active NPI

Mary Adrienne Newell, MS

  • Marriage & Family Therapist
  • Moreno Valley, CA
National Provider Identifier
1063942548
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94854 Issued in CA
Practice address
12968 Frederick St Ste D
Moreno Valley, CA 92553-5229
Phone
(951) 452-8533
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 94854 CA Primary

Addresses

Primary practice location

12968 Frederick St Ste D
Moreno Valley, CA 92553-5229

Mailing address

12968 Frederick St Ste D
Moreno Valley, CA 92553-5229
Phone (951) 452-8533

Other practice location 1

2085 Rustin Ave
Riverside, CA 92507-2498
Phone (951) 715-5040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
94854CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063942548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12968 FREDERICK ST STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535229",
            "telephone_number": "951-452-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12968 FREDERICK ST STE D",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535229",
            "telephone_number": "951-452-8533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2085 Rustin Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925072498",
            "country_code": "US",
            "telephone_number": "951-715-5040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWELL",
        "first_name": "MARY",
        "middle_name": "ADRIENNE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.