Individual provider Active NPI

Mayra I Duarte, MFT

  • Marriage & Family Therapist
  • Redlands, CA
National Provider Identifier
1225090145
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC35948 Issued in CA
Practice address
101 E Redland Blvd
Suite 234
Redlands, CA 92373
Phone
(909) 335-3026
Fax
(909) 335-3167
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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 MFC35948 CA Primary

Addresses

Primary practice location

101 E Redland Blvd
Suite 234
Redlands, CA 92373

Mailing address

101 E Redland Blvd
Suite 234
Redlands, CA 92373
Phone (909) 335-3026

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240302000003 CA Practitioner - Marriage and Family Therapist 4183069941 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC35948CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 24, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Inlandpsych Redlands Inc CurrentSince Jan 22, 2024 Accepting new patients
Inlandpsych Redlands Inc CurrentSince Jan 22, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 24, 2024 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

701 Highland Springs Ave
Ste 7
Beaumont, CA 92223
Phone (951) 849-7455

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

255 Terracina Blvd
Ste 204
Redlands, CA 92373
Phone (909) 496-1266

Organizations & group practices 6

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1225090145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E REDLAND BLVD",
            "address_2": "SUITE 234",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-335-3026",
            "fax_number": "909-335-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E REDLAND BLVD",
            "address_2": "SUITE 234",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-335-3026",
            "fax_number": "909-335-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "MAYRA",
        "middle_name": "I",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC35948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.