Individual provider Active NPI

Angela Alice Ybarra

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1831455286
Registry record updated Aug 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 53050 Issued in CA
Practice address
1295 N Wishon Ave Ste 211
Fresno, CA 93728-2350
Phone
(559) 316-1097
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 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 MFC 53050 CA Primary

Addresses

Primary practice location

1295 N Wishon Ave Ste 211
Fresno, CA 93728-2350

Mailing address

1631 NE Broadway St
PMB 750
Portland, OR 97232
Phone (559) 316-1097

Other names 1

  • Angela Alice Mendez Former name

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
I20240916001258 CA Practitioner - Marriage and Family Therapist 9234670456 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC 53050CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Selah Counseling Inc. Marriage & Family Therapist CurrentSince Feb 11, 2018 Accepting new patients

Locations

1295 N Wishon Ave
Ste 211
Fresno, CA 93728
Phone (559) 316-1097

1631 NE Broadway St
Portland, OR 97232
Phone (888) 391-4999

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692403200000",
    "number": "1831455286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 NE BROADWAY ST",
            "address_2": "PMB 750",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "559-316-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 N WISHON AVE STE 211",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937282350",
            "telephone_number": "559-316-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YBARRA",
        "first_name": "ANGELA",
        "middle_name": "ALICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2023-08-19",
        "certification_date": "2023-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 53050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MENDEZ",
            "middle_name": "ALICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.