Dolores Maria Mast, LCSW 63286

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW 63286 Issued in CA

Practice address

17830 Arrow Blvd
Fontana, CA 92335-4037

Phone

(909) 356-6451

NPI assigned

Nov 28, 2007

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

• Ms. Dolores Maria Martinez Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1992987242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17830 ARROW BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354037",
            "telephone_number": "909-356-6415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17830 ARROW BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354037",
            "telephone_number": "909-356-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAST",
        "first_name": "DOLORES",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LCSW 63286",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 63286",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOLORES",
            "last_name": "MARTINEZ",
            "middle_name": "MARIA",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie J Martinez, MD
• Madonna Sue Mashburn, PHARMD
• Tracy Levett Mason, PMHNP-BC
• Joshua Massie
• Sarabjit Massoun, DDS
• Lauren Matsumoto, CPNP
• Matt-Phuoc Trinh, DMD DDS, Inc
• Peter N. Mattar, MD
• Michael Scott Mattice
• Sara Maul

• Clinical Social Worker in Fontana, CA
• Providers in Fontana, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.