Mallolo Resendes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

975 Flynn Rd
Camarillo, CA 93012-8704

Phone

(805) 445-7800

NPI assigned

Jan 29, 2019

Sex

Male

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

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1124582655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 LA PUERTA AVE",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930305557",
            "telephone_number": "805-607-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128704",
            "telephone_number": "805-445-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESENDES",
        "first_name": "MALLOLO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-29",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "D9781671",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cynthia Rendon
• Mariely Renteria
• Roy Repunte, OTR/L
• Dennis M. Reuer, D. C., P. T.
• Sara Reveles
• Roxanna Reyes Arias
• Rosalva Reyes-Castillo, MA
• Antonio Reyes Jr.

• Mental Health Counselor in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.