Mostafa Ismail Bushra

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT114477 Issued in CA

Practice address

3125 Myers St
Riverside, CA 92503-5527

Phone

(951) 358-4840

NPI assigned

Jun 2, 2014

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1346652989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 MYERS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035527",
            "telephone_number": "951-358-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 MYERS ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035527",
            "telephone_number": "951-358-4840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3845 Avocado School Rd",
            "address_purpose": "LOCATION",
            "city": "La Mesa",
            "state": "CA",
            "postal_code": "91945",
            "country_code": "US",
            "telephone_number": "619-588-3653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHRA",
        "first_name": "MOSTAFA",
        "middle_name": "ISMAIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF91034",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT114477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desirae D'Shawn Bush
• Natalie Ariana Bush
• Sharnett Simone Bush, BHS
• Halee Bushman
• Taylor Bushong
• Dean Erick Busser, FNP-BC
• Diana Bustamante Valladares
• Lluvia Bustamante-Tapia
• Alexa Jeanine Bustamante, M.S., APCC
• Michelle Madeline Bustamante

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, 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 Apr 23, 2021; 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.