Fred Ignacio Mata Jr.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1885 Lundy Ave
Ste 223
San Jose, CA 95131-1887

Phone

(408) 503-7960

NPI assigned

Jun 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1720249295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 LUNDY AVE",
            "address_2": "STE 223",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311887",
            "telephone_number": "408-503-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 LUNDY AVE",
            "address_2": "STE 223",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311887",
            "telephone_number": "408-503-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "FRED",
        "middle_name": "IGNACIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert S Mastman, M.D.
• Aubrie Mastrangelo, LCSW
• Linda Mastrangelo, LMFT
• Angelito Mata Jr.
• Dolores Irene Mata
• Hannah Mata
• Joshua Mata
• Maria Yvonne Mata
• Ricardo Ochoa Mata
• Vanessa Mata

• All providers in San Jose, CA
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.