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NPI Code Detail

MEDICARE: MS. MAURA R. GONZALEZ MFT

MEDICARE:  MS. MAURA R. GONZALEZ  MFT
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1205953635
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAURA R. GONZALEZ MFT
Provider Business Mailing Address
First Line : 2309 DALY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2230
Country : US
Telephone Number : 323-261-7810
Fax Number : 323-222-4614
Provider Business Practice Location Address
First Line : 2309 DALY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2230
Country : US
Telephone Number : 323-261-7810
Fax Number : 323-222-4614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 04/09/2018

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Directions to “ MS. MAURA R. GONZALEZ MFT” Practice Location

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