Individual provider Active NPI

Mary Jill Raiguel, M.F.T.

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1790920718
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT 7746 Issued in CA
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

Updated by the provider on Dec 4, 2008

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241107002039 CA Practitioner - Marriage and Family Therapist 4183158587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT 7746CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosewood Counseling Center, Inc. Marriage & Family Therapist CurrentSince Oct 15, 2024 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

Verify at the official NPI Registry.