Active NPI
Mary Jill Raiguel, M.F.T.
- Marriage & Family Therapist
- San Bernardino, CA
National Provider Identifier
1790920718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 7746
- Practice address
- 1800 Medical Center Dr
300
San Bernardino, CA 92411-1218 - Phone
- (909) 887-6222
- Fax
- (909) 887-4565
- NPI assigned
- Dec 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT 7746 | CA | Primary |
Addresses
Primary practice location
1800 Medical Center Dr
300
San Bernardino, CA 92411-1218
Mailing address
1800 Medical Center Dr
300
San Bernardino, CA 92411-1218
Phone (909) 887-6222
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 7746 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosewood Counseling Center, Inc. | Marriage & Family Therapist | Current | Accepting new patients |
Locations
288 W 9th St
Upland, CA 91786
Phone (909) 981-0270
Organizations & group practices 1
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": "1228348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228348800000",
"number": "1790920718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 MEDICAL CENTER DR",
"address_2": "300",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924111218",
"telephone_number": "909-887-6222",
"fax_number": "909-887-4565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MEDICAL CENTER DR",
"address_2": "300",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924111218",
"telephone_number": "909-887-6222",
"fax_number": "909-887-4565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIGUEL",
"first_name": "MARY",
"middle_name": "JILL",
"name_prefix": "Ms.",
"credential": "M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-04",
"last_updated": "2008-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT 7746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.