Individual provider Active NPI

Mathew Gregory Fontes, MA

  • Marriage & Family Therapist
  • Colusa, CA
National Provider Identifier
1952701732
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT138254 Issued in CA
Practice address
3710 Highway 45
Colusa, CA 95932-4026
Phone
(530) 458-5501
Fax
(530) 458-8660
NPI assigned
Aug 28, 2014
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH12762 FL
Mental Health Counselor 101YM0800X LPCC8490 CA
Marriage & Family Therapist 106H00000X MT3972 FL
Marriage & Family Therapist 106H00000X LMFT138254 CA Primary

Addresses

Primary practice location

3710 Highway 45
Colusa, CA 95932-4026

Mailing address

3710 Highway 45
Colusa, CA 95932-4026
Phone (530) 458-5501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPCC8490CAMDMental Health Counselor
MH12762FLMDMental Health Counselor
LMFT138254CAMDMarriage & Family Therapist
MT3972FLMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1952701732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 HIGHWAY 45",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959324026",
            "telephone_number": "530-458-5501",
            "fax_number": "530-458-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 HIGHWAY 45",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959324026",
            "telephone_number": "530-458-5501",
            "fax_number": "530-458-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTES",
        "first_name": "MATHEW",
        "middle_name": "GREGORY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12762",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC8490",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3972",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT138254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.