Healthcare Provider Details

I. General information

NPI: 1891699872
Provider Name (Legal Business Name): ANNA GABRIELLA RAJO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 S PLYMOUTH BLVD
LOS ANGELES CA
90005-3741
US

IV. Provider business mailing address

854 S PLYMOUTH BLVD
LOS ANGELES CA
90005-3741
US

V. Phone/Fax

Practice location:
  • Phone: 323-448-2657
  • Fax:
Mailing address:
  • Phone: 323-448-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: