Jason Agnetti, MFT
Individual provider Active NPI Marriage & Family Therapist · Temecula, CA
NPI 1326199449 · NPPES record last updated Aug 30, 2016
Key facts
- NPI
- 1326199449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFC 37925 (CA)
- Practice address
- 29748 Rancho California Rd
Temecula, CA 92591-5286 - Phone
- (951) 694-0695
- Fax
- (951) 695-6215
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Novell and Novell Counseling
Practice addresses (Care Compare)
29748 Rancho California Rd
Temecula, CA 92591-5286
Phone (951) 694-0695
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240108004638 | CA | Practitioner - Marriage and Family Therapist | 4284085853 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 37925 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novell & Novell Counseling | Marriage & Family Therapist | Current |
Accepting new patients |
| Novell & Novell Counseling Services, Inc. | Marriage & Family Therapist | Past |
Accepting new patients |
Locations
29748 Rancho California Rd
Temecula, CA 92591
Phone (951) 252-9911
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 37925 | CA | Yes |
Addresses
Primary practice location
29748 Rancho California Rd
Temecula, CA 92591-5286
Mailing address
29748 Rancho California Rd
Temecula, CA 92591-5286
Phone (951) 694-0695
Other providers in Temecula, CA
- Cyan Agena
- Nina Marie Aghakhani
- Robin M Aghbashian
- Rozeta Aglione
- Agm Medical Group, P.C.
- Maria Socorro Agorrilla
- Aditya Agrawal
- Nina Rebecca Aguele
- Aida Aguilar
- Priscilla Aguilar
All providers in Temecula, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.