Healthcare Provider Details

I. General information

NPI: 1003334327
Provider Name (Legal Business Name): CIANA GONZALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 PACIFIC COAST HWY STE 202
HERMOSA BEACH CA
90254-2753
US

IV. Provider business mailing address

2309 PACIFIC COAST HWY STE 202
HERMOSA BEACH CA
90254-2753
US

V. Phone/Fax

Practice location:
  • Phone: 213-342-5928
  • Fax:
Mailing address:
  • Phone: 213-342-5928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: