Active NPI
Maria Lizbeth Mazcoro
- Marriage & Family Therapist
- Wasco, CA
National Provider Identifier
1376099648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 117650
- Practice address
- 29325 Kimberlina Rd.
Wasco, CA 93280 - Phone
- (661) 758-4029
- Fax
- (661) 758-0891
- NPI assigned
- Aug 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 117650 | CA | Primary |
Addresses
Primary practice location
29325 Kimberlina Rd.
Wasco, CA 93280
Mailing address
29325 Kimberlina Rd.
Wasco, CA 93280
Phone (661) 758-4029
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
| License | State | Type | Specialty |
|---|---|---|---|
| 117650 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| College Community Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Tehachapi, CA
- NPI 1831870500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1376099648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29325 KIMBERLINA RD.",
"city": "WASCO",
"state": "CA",
"postal_code": "93280",
"telephone_number": "661-758-4029",
"fax_number": "661-758-0891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29325 KIMBERLINA RD.",
"city": "WASCO",
"state": "CA",
"postal_code": "93280",
"telephone_number": "661-758-4029",
"fax_number": "661-758-0891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZCORO",
"first_name": "MARIA",
"middle_name": "LIZBETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-28",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "117650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.