Healthcare Provider Details

I. General information

NPI: 1144427774
Provider Name (Legal Business Name): PAOLA GONZALES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAOLA MACHON LMFT

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8291 UTICA AVE
RANCHO CUCAMONGA CA
91730-7614
US

IV. Provider business mailing address

8291 UTICA AVE OFC 212
RANCHO CUCAMONGA CA
91730-7614
US

V. Phone/Fax

Practice location:
  • Phone: 909-278-7866
  • Fax: 909-474-7344
Mailing address:
  • Phone: 909-278-7866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number117160
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number73310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: