Jailene Stacey Mazariegos

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

330 N Maclay Ave Ste 206
San Fernando, CA 91340-2955

Phone

(818) 351-6717

NPI assigned

Sep 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Therapeutic Services Healing and Growth Inc

  • Adolescent and Children Mental Health Clinic/Center
  • San Fernando, CA
  • NPI 1114686839
  NPD

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1487323390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 COSTELLO AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054827",
            "telephone_number": "818-808-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N MACLAY AVE STE 206",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402955",
            "telephone_number": "818-351-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZARIEGOS",
        "first_name": "JAILENE",
        "middle_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mauran Ambulance Service Inc
• Maya Chiropractic Center Inc
• Antonio Eduardo Maya, D.C.
• Karen Maya
• Afsaneh Mazaheri-Sichani
• Medcoast Pharmacy Corp
• Paul Medina
• Sara Medina, REGISTERED NURSE
• Wendy Aguilar Medina
• Mednova Partners LLC

• Marriage & Family Therapist in San Fernando, CA
• Providers in San Fernando, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.