Individual provider Active NPI

Carlton Patrick Mascarella, MA

  • Marriage & Family Therapist
  • Victorville, CA
National Provider Identifier
1194984484
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 29791 Issued in CA
Practice address
14360 Saint Andrews Dr
Suite 11
Victorville, CA 92395-4358
Phone
(760) 243-5417
Fax
(760) 513-4696
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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 MFC 29791 CA Primary

Addresses

Primary practice location

14360 Saint Andrews Dr
Suite 11
Victorville, CA 92395-4358

Mailing address

14360 Saint Andrews Dr
Suite 11
Victorville, CA 92395-4358
Phone (760) 243-5417

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 Arts

State licenses

LicenseStateTypeSpecialty
MFC 29791CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1194984484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14360 SAINT ANDREWS DR",
            "address_2": "SUITE 11",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954358",
            "telephone_number": "760-243-5417",
            "fax_number": "760-513-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14360 SAINT ANDREWS DR",
            "address_2": "SUITE 11",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954358",
            "telephone_number": "760-243-5417",
            "fax_number": "760-513-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARELLA",
        "first_name": "CARLTON",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 29791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.