Mariejose Balleza Fichtner, MFTI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF93087 Issued in CA

Practice address

3075 Myers St BLDG 1
Riverside, CA 92503-5525

Phone

(951) 358-6895

NPI assigned

Jul 7, 2017

Last updated

Jul 7, 2017By 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 1

Addresses

Other names 1

• Mariejose Balleza Ruiz Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wise Mind Counseling Services Inc.

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1598300642
  Medicare reassignment NPD

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1194247593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 MYERS ST BLDG 1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 MYERS ST BLDG 1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035525",
            "telephone_number": "951-358-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICHTNER",
        "first_name": "MARIEJOSE",
        "middle_name": "BALLEZA",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF93087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIEJOSE",
            "last_name": "RUIZ",
            "middle_name": "BALLEZA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Fetterleigh
• Fiatm Family Services Inc (FIATM Family Counseling Services Inc)
• Fiatm Industries LLC
• Aaron Fichtner, MD
• Christopher G. Fichtner, MD
• Cedric Fields
• Hunter Logan Fields
• Ilee Fields
• Gustavo Fierro, MSW, CATVIV
• Nadine Fierro

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, 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 Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.