Individual provider Active NPI

Karla Cortez

  • Marriage & Family Therapist
  • Fontana, CA
National Provider Identifier
1366828873
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
124925 Issued in CA
Practice address
17046 Marygold Ave
Fontana, CA 92335-1722
Phone
(866) 205-3595
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 124925 CA Primary

Addresses

Primary practice location

17046 Marygold Ave
Fontana, CA 92335-1722

Mailing address

1950 S Sunwest LN
San Bernardino, CA 92408-3258
Phone (909) 252-4010

Other practice location 1

222 E Main St Ste 117
Barstow, CA 92311-2361
Phone (760) 255-1496

Other practice location 2

1950 S Sunwest Ln
San Bernardino, CA 92408-3258
Phone (909) 252-4010

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
I20241126003541 CA Practitioner - Marriage and Family Therapist 3779018874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124925CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 22, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 22, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

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

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

Organizations & group practices 3

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": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1366828873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S SUNWEST LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083258",
            "telephone_number": "909-252-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17046 MARYGOLD AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923351722",
            "telephone_number": "866-205-3595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 E Main St Ste 117",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112361",
            "country_code": "US",
            "telephone_number": "760-255-1496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 S Sunwest Ln",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083258",
            "country_code": "US",
            "telephone_number": "909-252-4010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "KARLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.