Healthcare Provider Details

I. General information

NPI: 1942132857
Provider Name (Legal Business Name): CENTER OF MENTAL AND SPIRITUAL WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 W POPLAR ST
COMPTON CA
90220-1457
US

IV. Provider business mailing address

1716 W POPLAR ST
COMPTON CA
90220-1457
US

V. Phone/Fax

Practice location:
  • Phone: 425-366-6753
  • Fax:
Mailing address:
  • Phone: 425-366-6753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LONDEN GATEWOOD
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT
Phone: 818-447-1451