Stephanie Fuentes

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

308 E San Jacinto Ave
Perris, CA 92570-2878

Phone

(951) 943-1130

NPI assigned

Aug 18, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie Mares Former name

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Blue Psychological ServicesGroup PAC ID 3678908357, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pacific Blue Psychological Services

  • Psychologist
  • Sherman Oaks, CA
  • NPI 1124678719
  Medicare reassignment Care Compare group NPD
• Spring to Autumn Family Counseling, Inc.

  • Marriage & Family Therapist
  • Redlands, CA
  • NPI 1689056442
  Medicare reassignment NPD

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1962801795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E SAN JACINTO AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702878",
            "telephone_number": "951-943-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E SAN JACINTO AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702878",
            "telephone_number": "951-943-1130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 Myers St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925035525",
            "country_code": "US",
            "telephone_number": "951-358-4901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1688 N Perris Blvd Ste L1-2",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925714709",
            "country_code": "US",
            "telephone_number": "951-943-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MARES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheyenne Franklin
• Andrew Freeman
• Fresh Smiles Erica Macias Dental Hygiene Practice
• Allie Frey
• Mariana Fuentes, CHW
• Yeslee Arelis Fuentes
• Yolanda Velazquez Fullinwider, MA
• Stephen Gafford
• Steven Anthony Galatioto
• Dana Caroline Galazzo, LVN

• Marriage & Family Therapist in Perris, CA
• Providers in Perris, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.