Mary Jo Pedersen, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMFT38335 Issued in CA

Practice address

2355 Lake Marie Drive
Santa Maria, CA 93455

Phone

(805) 934-5088

Fax

(805) 937-0877

NPI assigned

Jul 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 2, 2024 through Jan 2, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Central Coast Counseling Center, Inc.

  • Marriage & Family Therapist
  • Santa Maria, CA
  • NPI 1861686602
  NPD Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1407889686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2234",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934572234",
            "telephone_number": "805-264-2584",
            "fax_number": "805-937-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 LAKE MARIE DRIVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93455",
            "telephone_number": "805-934-5088",
            "fax_number": "805-937-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "MARY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC 38335",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT38335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynda Loie Paxton
• Maria Angeles Paz Camacho, MFT
• Paz FCC
• Justine Paz
• Anne Pedersen, D.D.S.
• Pediatric Inpatient Specialists PC
• Pediatric Medical Group of Santa Maria Inc
• Edgar Pedraza
• Peds Care LLC
• Diana H. Peinado, LMFT

• Mental Health Counselor in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.