Maria C Masullo

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT151148 Issued in CA

Practice address

2180 Johnson Ave
San Luis Obispo, CA 93401-4558

Phone

(805) 781-4275

Fax

(805) 781-4866

NPI assigned

Feb 1, 2021

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1508457599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014558",
            "telephone_number": "805-781-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014558",
            "telephone_number": "805-781-4275",
            "fax_number": "805-781-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASULLO",
        "first_name": "MARIA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT151148",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydie Mason
• John Massaro, DO
• Brandi Lee Massengale Cuellar, C.A.T.C.
• Amanda Masters
• Melissa Masters
• Carlin Joy Matejka, ACSW 123506
• Michael Eugene Mathes, LVN, AEMT
• Dan Matich
• Matrix Medical Corporation
• Rory Matson, ED.S.

• Marriage & Family Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 Dec 3, 2024; 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.