Individual provider Active NPI

Selena Aguilera

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1396407805
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
145564 Issued in CA
Practice address
2582 Ogden St
San Bernardino, CA 92407-6156
Phone
(909) 771-3439
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 125008 CA
Marriage & Family Therapist 106H00000X 145564 CA Primary

Addresses

Primary practice location

2582 Ogden St
San Bernardino, CA 92407-6156

Mailing address

2582 Ogden St
San Bernardino, CA 92407-6156
Phone (909) 771-3439

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
I20251002001694 CA Practitioner - Marriage and Family Therapist 7012413610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13014 W Greenfield Rd
Nine Mile Falls, WA 99026-9361

PO Box
Suite 7461
Redlands, CA 92375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125008CAMDMental Health Counselor
145564CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring to Autumn Family Counseling, Inc. Marriage & Family Therapist CurrentSince Sep 18, 2025 Accepting new patients

Locations

1275 W Park Ave
#7461
Redlands, CA 92373

2068 Orange Tree Ln
Ste 216
Redlands, CA 92374
Phone (909) 553-0448

11870 Pierce St
Ste 150
Riverside, CA 92505
Phone (909) 557-6574

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.

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1396407805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2582 OGDEN ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924076156",
            "telephone_number": "909-771-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2582 OGDEN ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924076156",
            "telephone_number": "909-771-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "SELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "125008",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.