Active NPI
Mary Jo Phipps
- Marriage & Family Therapist
- Riverside, CA
National Provider Identifier
1609063593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 769 W Blaine St Ste B
Riverside, CA 92507-3970 - Phone
- (951) 358-4705
- Fax
- (951) 358-4719
- NPI assigned
- Sep 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CA | Primary |
Addresses
Primary practice location
769 W Blaine St Ste B
Riverside, CA 92507-3970
Mailing address
769 W Blaine St Ste B
Riverside, CA 92507-3970
Phone (951) 358-4705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376438400000",
"number": "1609063593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "769 W BLAINE ST STE B",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925073970",
"telephone_number": "951-358-4705",
"fax_number": "951-358-4719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "769 W BLAINE ST STE B",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925073970",
"telephone_number": "951-358-4705",
"fax_number": "951-358-4719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHIPPS",
"first_name": "MARY",
"middle_name": "JO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-25",
"last_updated": "2013-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.