Active NPI
Gabriela Fonteyn, MSW
- Mental Health Counselor
- Glendora, CA
National Provider Identifier
1609438894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW88841
- Practice address
- 2200 E Route 66
Glendora, CA 91740-4659 - Phone
- (626) 859-2089
- NPI assigned
- Jul 8, 2019
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW88841 | CA | Primary |
Addresses
Primary practice location
2200 E Route 66
Glendora, CA 91740-4659
Mailing address
2200 E Route 66
Glendora, CA 91740-4659
Phone (626) 859-2089
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW88841 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for Family Centered Services Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1992188544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1609438894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 E ROUTE 66",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404659",
"telephone_number": "626-859-2089",
"fax_number": "626-859-6537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 E ROUTE 66",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404659",
"telephone_number": "626-859-2089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTEYN",
"first_name": "GABRIELA",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-08",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW88841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.