Individual provider Active NPI

Mauricio Antonio Chavez

  • Mental Health Counselor
  • Fullerton, CA
National Provider Identifier
1205185881
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846
Phone
(714) 680-9000
Fax
(714) 680-8233
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846

Mailing address

PO Box 919
Fullerton, CA 92836-0919
Phone (714) 680-9000

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

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients
Crittenton Services PastSince Feb 2, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mauriciochavez-shieldsforfamilies@lacsapc.netsmartdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1205185881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928360919",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E CHAPMAN AVE STE 203",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313846",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "MAURICIO",
        "middle_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.