Organization Active NPI

Nina Gonzaga, Licensed Marriage and Family Therapist, Inc.

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1114622255
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NINA GONZAGA, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Practice address
11440 W. Bernardo CT
Suite 300
San Diego, CA 92127
Phone
(951) 505-0571
NPI assigned
Mar 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Nina Gonzaga, LMFTNPI 1033589155
Title
Owner
Phone
(951) 505-0571

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

11440 W. Bernardo CT
Suite 300
San Diego, CA 92127

Mailing address

1125 E Broadway # 836
Glendale, CA 91205-1315
Phone (951) 505-0571

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1114622255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E BROADWAY # 836",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051315",
            "telephone_number": "951-505-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 W. BERNARDO CT",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92127",
            "telephone_number": "951-505-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINA GONZAGA, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "GONZAGA",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-505-0571",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.