MEDICARE: MARIA GUADALUPE ANGUIANO LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist	138539	CA

General Provider Information

NPI Number	:	1154812055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA GUADALUPE ANGUIANO LMFT

Provider Business Mailing Address
First Line	:	4730 PALM AVE STE 211
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5244
Country	:	US
Telephone Number	:	619-273-0916
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 PALM AVE STE 211
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-5244
Country	:	US
Telephone Number	:	619-273-0916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2018
Last Update Date	:	07/24/2025

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