Individual provider Active NPI

Patricia Mireles, LMFT

  • Marriage & Family Therapist
  • Modesto, CA
National Provider Identifier
1679605646
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT34697 Issued in CA
Practice address
500 N 9TH St Ste C
Modesto, CA 95350-5814
Phone
(209) 552-2743
NPI assigned
Mar 12, 2007
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT34697 CA Primary

Addresses

Primary practice location

500 N 9TH St Ste C
Modesto, CA 95350-5814

Mailing address

500 N 9TH St Ste C
Modesto, CA 95350-5814
Phone (209) 552-2743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326000000 CA Practitioner - Marriage and Family Therapist 5890132997 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of StanislausGroup PAC ID 0648183996, shared by 8 NPIs, 19 clinicians

Practice addresses (Care Compare)

1904 Richland Ave
BLDG F
Ceres, CA 95307-4562
Phone (209) 525-5369

500 N 9TH St
Suite a
Modesto, CA 95350-5814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT34697CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Stanislaus Current Accepting new patients
County of Stanislaus CurrentSince Feb 11, 2024 Accepting new patients
County of Stanislaus CurrentSince Feb 11, 2024 Accepting new patients
County of Stanislaus Current Accepting new patients
County of Stanislaus CurrentSince Feb 11, 2024 Accepting new patients
County of Stanislaus CurrentSince Feb 11, 2024 Accepting new patients

Locations

1904 Richland Ave
Bldg F
Ceres, CA 95307
Phone (209) 525-7466

500 N 9th St
Ste A
Modesto, CA 95350
Phone (209) 525-5300

500 N 9th St
Ste B
Modesto, CA 95350
Phone (209) 341-1824

500 N 9th St
Ste C
Modesto, CA 95350
Phone (209) 552-2720

800 Scenic Dr
Modesto, CA 95350
Phone (209) 525-5369

2101 Geer Rd
Ste 120
Turlock, CA 95382
Phone (209) 558-4598

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1679605646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N 9TH ST STE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505814",
            "telephone_number": "209-552-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 9TH ST STE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505814",
            "telephone_number": "209-552-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2023-12-14",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT34697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.