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MARIO ANTONIO SOUZA PSY.D.
NPI 1386083012
Psychologist - Forensic in Patton, CA

Active since June 15, 2013PECOS Enrolled
3102 E HIGHLAND AVE, PATTON, CA 92369(909) 425-7000 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mario Antonio Souza Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIO ANTONIO SOUZA PSY.D. (NPI 1386083012) is an individual forensic provider in Patton, California, licensed in California (D6738240) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386083012
Entity TypeIndividualMale
Primary Taxonomy103TF0200X
Provider Legal NameMARIO ANTONIO SOUZACredential: PSY.D.
Location Address3102 E HIGHLAND AVEPatton, CA 92369-7813
Mailing Address3404 Santa Carlotta StLa Crescenta, CA 91214-1158 · (818) 395-0331
Phone(909) 425-7000
Sole ProprietorYes
Enumeration DateJune 15, 2013
Last NPPES UpdateMarch 18, 2024
NPPES CertifiedMarch 18, 2024
✔ NPI 1386083012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ForensicBehavioral Health & Social Service Providers
Taxonomy Code103TF0200X
License✔ Licensed in CA · D6738240
Definition
A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
3102 E HIGHLAND AVE, Patton, CA 92369
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mario Antonio Souza Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL DALE DEWIT LCSW
Social Worker (Clinical)
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 425-7000
JIALI LUAN MD
Psychiatry & Neurology (Psychiatry)
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 425-7000
DR. DEVIN RANDLE PSY.D.
Psychologist (Clinical)
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 672-6394
DEPARTMENT OF STATE HOSPITALS
Psychiatric Hospital
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 425-7552
JEFFREY WALSH M.D.
Psychiatry & Neurology (Psychiatry)
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 425-7000
DR. VICTORIA MAY KING PALENSCAR PSY.D.
Psychologist
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 425-7791
DR. GREGORY GENE MCGOWAN M.D.
Psychiatry & Neurology (Psychiatry)
3102 E HIGHLAND AVE, MEDICAL STAFF OFFICE
PATTON, CA 92369
San Bernardino County (909) 425-7679
DR. TROY STEVEN FREIMUTH PSY. D.
Psychologist (Clinical)
3102 E HIGHLAND AVE
PATTON, CA 92369
San Bernardino County (909) 425-6043

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mario Souza's NPI number?

The NPI number for Mario Souza is 1386083012. It was assigned to this individual provider in the NPPES registry on June 15, 2013.

Where is Mario Souza located?

Mario Souza practices at 3102 E Highland Ave, Patton, CA 92369. The listed phone number is (909) 425-7000.

What is Mario Souza's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Forensic, with taxonomy code 103TF0200X.

Is Mario Souza enrolled in Medicare?

Yes. Mario Souza is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mario Souza was last updated on March 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.