Mariella Gonzalez

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

147168 Issued in CA

Practice address

1025 Sentinel Dr
La Verne, CA 91750-3280

Phone

(098) 332-9869

NPI assigned

Jan 30, 2018

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD
• Haynes Family of Programs

  • Mental Illness Community Based Residential Treatment Facility
  • La Verne, CA
  • NPI 1164548236
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1063910560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SENTINEL DR",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503280",
            "telephone_number": "909-593-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SENTINEL DR",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917503280",
            "telephone_number": "098-332-9869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Sentinel Dr",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917503280",
            "country_code": "US",
            "telephone_number": "909-593-2581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147168",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Ignacio Gomez, BA
• Priscella Gomez
• Diana Gonzalez
• Jazmin Gonzalez
• Linda Armida Gonzalez
• Samantha Graaf, LPT
• Delaney Kay Grafius, OTR/L
• Carmen Graham
• Green Family Tree, Inc. (Green Family Therapies)
• Alexandria Green, MS, SLP

• Marriage & Family Therapist in La Verne, CA
• Providers in La Verne, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.