Individual provider Active NPI

Saniyyah Shaleece Mayo

  • Marriage & Family Therapist
  • Upland, CA
National Provider Identifier
1780153692
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
103963 Issued in CA
Practice address
219 N Euclid Ave Ste B
Upland, CA 91786-6038
Phone
(909) 660-3624
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 103963 CA Primary

Addresses

Primary practice location

219 N Euclid Ave Ste B
Upland, CA 91786-6038

Mailing address

12223 Highland Ave # 106-580
Rancho Cucamonga, CA 91739-2574
Phone (909) 660-3624

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

LicenseStateTypeSpecialty
103963CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Girls Gossip and Women Network LLC Single Specialty Current Accepting new patients
Simple Solutions Family Therapy Marriage & Family Therapist Current Accepting new patients
Rise to Grind Foundation Current Accepting new patients

Locations

8350 Archibald Ave
Ste 110
Rancho Cucamonga, CA 91730
Phone (909) 244-9311

12223 Highland Ave
Rch Cucamonga, CA 91739
Phone (404) 932-7220

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1780153692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12223 HIGHLAND AVE # 106-580",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392574",
            "telephone_number": "909-660-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N EUCLID AVE STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866038",
            "telephone_number": "909-660-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "SANIYYAH",
        "middle_name": "SHALEECE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "103963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.