Individual provider Active NPI

Mikaela Zuniga, DSW, LMFT

  • Marriage & Family Therapist
  • Fontana, CA
National Provider Identifier
1861934275
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117931 Issued in CA
Practice address
14515 Woodland Dr Unit 13
Fontana, CA 92337-0102
Phone
(909) 437-4627
NPI assigned
Nov 16, 2016
Reactivated
Feb 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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 117931 CA Primary

Addresses

Primary practice location

14515 Woodland Dr Unit 13
Fontana, CA 92337-0102

Mailing address

14515 Woodland Dr Unit 13
Fontana, CA 92337-0102
Phone (909) 437-4627

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
I20250313001887 CA Practitioner - Marriage and Family Therapist 0042732547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117931CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Jan 5, 2025 Accepting new patients
Telecare Corporation PastSince Jan 1, 2022 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1861934275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14515 WOODLAND DR UNIT 13",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923370102",
            "telephone_number": "909-437-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14515 WOODLAND DR UNIT 13",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923370102",
            "telephone_number": "909-437-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUNIGA",
        "first_name": "MIKAELA",
        "name_prefix": "Dr.",
        "credential": "DSW, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "deactivation_date": "2025-01-22",
        "reactivation_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.