Individual provider Active NPI

Maribel Paloma M. Fuentes, M.A., LMFT

  • Marriage & Family Therapist
  • Redwood City, CA
National Provider Identifier
1619098365
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
98491 Issued in CA
Practice address
3756 Florence St
Redwood City, CA 94063-4418
Phone
(650) 556-4652
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Marriage & Family Therapist 106H00000X 98491 CA Primary

Addresses

Primary practice location

3756 Florence St
Redwood City, CA 94063-4418

Mailing address

PO Box 1161
Palo Alto, CA 94302-1161
Phone (650) 556-4652

Other practice location 1

2560 Pulgas Ave
East Palo Alto, CA 94303-1323
Phone (650) 556-4652

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
98491CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1619098365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1161",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943021161",
            "telephone_number": "650-556-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3756 FLORENCE ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940634418",
            "telephone_number": "650-556-4652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2560 Pulgas Ave",
            "address_purpose": "LOCATION",
            "city": "East Palo Alto",
            "state": "CA",
            "postal_code": "943031323",
            "country_code": "US",
            "telephone_number": "650-556-4652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "MARIBEL PALOMA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.