Individual provider Active NPI

Cynthia Lusy Salazar, LMFT

  • Marriage & Family Therapist
  • Fontana, CA
National Provider Identifier
1891145041
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
140997 Issued in CA
Practice address
15379 Parsley Leaf PL
Fontana, CA 92336-3396
Phone
(909) 919-0086
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 140997 CA Primary

Addresses

Primary practice location

15379 Parsley Leaf PL
Fontana, CA 92336-3396

Mailing address

15379 Parsley Leaf PL
Fontana, CA 92336-3396
Phone (909) 919-0086

Other practice location 1

11780 Central Ave Ste 125
Chino, CA 91710-6498
Phone (951) 557-4978

Other identifiers 1

IdentifierTypeStateIssuer
1891145041MedicaidCA

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
I20240510002758 CA Practitioner - Marriage and Family Therapist 7719328541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
An Elegant Sufficiency a Psychological CorporationGroup PAC ID 7315359445, 9 clinicians

Practice addresses (Care Compare)

2431 W March LN
Suite 200
Stockton, CA 95207-8211
Phone (877) 693-3357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
140997CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
An Elegant Sufficiency, a Psychological Corporation CurrentSince Apr 30, 2024 Accepting new patients
A New Outcome, LLC Marriage & Family Therapist Current Accepting new patients
New Day Recovery Center, Inc. Marriage & Family Therapist Current Accepting new patients

Locations

5250 Claremont Ave
Ste 118
Stockton, CA 95207
Phone (209) 200-8305

2431 W March Ln
Ste 200
Stockton, CA 95207
Phone (209) 200-8305

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1891145041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15379 PARSLEY LEAF PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363396",
            "telephone_number": "909-919-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15379 PARSLEY LEAF PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363396",
            "telephone_number": "909-919-0086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11780 Central Ave Ste 125",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917106498",
            "country_code": "US",
            "telephone_number": "951-557-4978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "CYNTHIA",
        "middle_name": "LUSY",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891145041",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.