Individual provider Active NPI

Mattie Celine Duran

  • Marriage & Family Therapist
  • Grand Terrace, CA
National Provider Identifier
1356092779
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147452 Issued in CA
Practice address
21935 Van Buren St
Grand Terrace, CA 92313-5652
Phone
(909) 906-1023
NPI assigned
Jan 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 147452 CA Primary
Professional Counselor 101YP2500X 17053 CA

Addresses

Primary practice location

21935 Van Buren St
Grand Terrace, CA 92313-5652

Mailing address

21935 Van Buren St
Grand Terrace, CA 92313-5652
Phone (909) 906-1023

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

State licenses

LicenseStateTypeSpecialty
17053CAMDProfessional Counselor
147452CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1356092779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21935 VAN BUREN ST",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135652",
            "telephone_number": "909-906-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21935 VAN BUREN ST",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135652",
            "telephone_number": "909-906-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "MATTIE CELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147452",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "17053",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.