Michael Wayne Bettis

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

117278 Issued in CA

Practice address

850 E Foothill Blvd
Rialto, CA 92376-5230

Phone

(909) 580-2141

Fax

(909) 580-2866

NPI assigned

Oct 2, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

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 and National Provider Directory roles.

• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007
  Medicare reassignment NPD

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1275885113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4286 STONEBRIAR CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928830671",
            "telephone_number": "951-415-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-580-2141",
            "fax_number": "909-580-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTIS",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "76826",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "117278",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Jeffrey Berglund, MD
• Berkeley Diagnostic Lab LLC
• Vivian E. Bermudez, M.S. - CLINICAL PSY
• Matias G Bernal
• Bernard Rubin, O.D., Inc.
• Brittany Leigh Bev
• Zajria Monique Bey
• Sophia Beyene, DO
• Darshan Satish Bhakta, PHARM. D.
• James F. Bierman, PH.D.

• Marriage & Family Therapist in Rialto, CA
• Providers in Rialto, 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 Sep 8, 2020; 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.