Active NPI
Matthew Zackary Bethell, BA
- Marriage & Family Therapist
- Fresno, CA
National Provider Identifier
1386145472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 132252
- Practice address
- 1879 E Fir Ave Ste 103
Fresno, CA 93720-3861 - Phone
- (559) 323-8484
- Fax
- (000) 000-0000
- NPI assigned
- Feb 23, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 132252 | CA | Primary |
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
1879 E Fir Ave Ste 103
Fresno, CA 93720-3861
Mailing address
1879 E Fir Ave Ste 103
Fresno, CA 93720-3861
Phone (559) 323-8484
Other practice location 1
27502 Avenue Scott
Valencia, CA 91355-3484
Phone (661) 670-2999
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132252 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roubicek & Shaw | Marriage & Family Therapist | Past | Accepting new patients |
| Roubicek & Thacker | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 2
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": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650499200000",
"number": "1386145472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1879 E FIR AVE STE 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203861",
"telephone_number": "559-323-8484",
"fax_number": "000-000-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1879 E FIR AVE STE 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203861",
"telephone_number": "559-323-8484",
"fax_number": "000-000-0000"
}
],
"practiceLocations": [
{
"address_1": "27502 Avenue Scott",
"address_purpose": "LOCATION",
"city": "Valencia",
"state": "CA",
"postal_code": "913553484",
"country_code": "US",
"telephone_number": "661-670-2999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BETHELL",
"first_name": "MATTHEW",
"middle_name": "ZACKARY",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-23",
"last_updated": "2022-04-21",
"certification_date": "2022-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "132252",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.