Roxanne Marie Mata, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

129867 Issued in CA

Practice address

5300 Angeles Vista Blvd
View Park, CA 90043-1648

Phone

(323) 295-4555

NPI assigned

Feb 5, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tri-City Mental Health Authority

  • Community/Behavioral Health Agency
  • Pomona, CA
  • NPI 1346304920
  NPD (past)
• Tri-City Mental Health Center

  • Case Management Agency
  • Pomona, CA
  • NPI 1255651501
  NPD (past)

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

{
    "created_epoch": "1296864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1659677888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ANGELES VISTA BLVD",
            "city": "VIEW PARK",
            "state": "CA",
            "postal_code": "900431648",
            "telephone_number": "323-295-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ANGELES VISTA BLVD",
            "city": "VIEW PARK",
            "state": "CA",
            "postal_code": "900431648",
            "telephone_number": "323-295-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "ROXANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-05",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elysia Leassear
• Guiqing Liang
• Andrea Clarissia Major, B.A.
• Allison Martin
• Maria A Martinez Caballero
• Shayla Matthews
• Tammi Maxwell, LVN
• Shauna Renee' McClain, MSW, ACSW
• William-Zakee Howard McGill, MD
• Desiree Mendoza, MSW, ACSW

• Marriage & Family Therapist in View Park, CA
• Providers in View Park, 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 21, 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.