Individual provider Active NPI

Maura R. Gonzalez, MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1205953635
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2309 Daly St
Los Angeles, CA 90031-2230
Phone
(323) 261-7810
Fax
(323) 222-4614
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

2309 Daly St
Los Angeles, CA 90031-2230

Mailing address

2309 Daly St
Los Angeles, CA 90031-2230
Phone (323) 261-7810

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240814004910 CA Practitioner - Marriage and Family Therapist 9335687805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pure Autism Counseling Center IncGroup PAC ID 4284967167, 11 clinicians

Practice addresses (Care Compare)

17702 Sierra Hwy
Santa Clarita, CA 91351-1635
Phone (888) 770-5222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44100CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Autism Counseling Center Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

17702 Sierra Hwy
Santa Clarita, CA 91351
Phone (888) 770-5222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19641/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1205953635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 DALY ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312230",
            "telephone_number": "323-261-7810",
            "fax_number": "323-222-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 DALY ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900312230",
            "telephone_number": "323-261-7810",
            "fax_number": "323-222-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MAURA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.