Individual provider Active NPI

Jessica N Sanchez Fernandez

  • Marriage & Family Therapist
  • Ontario, CA
National Provider Identifier
1174122378
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
143355 Issued in CA
Practice address
3491 E Concours Street, Suite 202
Ontario, CA 91764
Phone
(909) 284-4504
NPI assigned
Oct 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 143355 CA Primary
Professional Counselor 101YP2500X 15419 CA

Addresses

Primary practice location

3491 E Concours Street, Suite 202
Ontario, CA 91764

Mailing address

3491 E Concours Street, Suite 202
Ontario, CA 91764
Phone (909) 284-4504

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1307 W 6TH St
Suite 108
Corona, CA 92882-1642

5598 Tilton Ave
Jurupa Valley, CA 92509-6738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Milestone Marriage and Family Therapy Services Professional Corporati Marriage & Family Therapist CurrentSince May 26, 2024 Accepting new patients

Locations

3491 Concours
Ste 202
Ontario, CA 91764
Phone (909) 284-4504

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": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1174122378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3491 E CONCOURS STREET, SUITE 202",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91764",
            "telephone_number": "909-284-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3491 E CONCOURS STREET, SUITE 202",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "91764",
            "telephone_number": "909-284-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ FERNANDEZ",
        "first_name": "JESSICA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143355",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "15419",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.