Gissele Lopez Gonzales, LICENSED MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 53779 Issued in CA

Practice address

4401 Crenshaw Blvd
Suite #300
Los Angeles, CA 90043-1227

Phone

(323) 290-8360

Fax

(323) 290-8366

NPI assigned

Jun 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wellnest Emotional Health & Wellness

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1639293574
  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1609036367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 CRENSHAW BLVD",
            "address_2": "SUITE #300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431227",
            "telephone_number": "323-290-8360",
            "fax_number": "323-290-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CRENSHAW BLVD",
            "address_2": "SUITE #300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431227",
            "telephone_number": "323-290-8360",
            "fax_number": "323-290-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "GISSELE",
        "middle_name": "LOPEZ",
        "credential": "LICENSED MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 53779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald J. Gonzales, LCSW
• Erica Gonzales
• Frankie Gonzales Jr.
• Fumiko Irene Fukumoto Gonzales, RADT
• Gabriella Gonzales, BSN, RN
• Jacqueline Gonzales, RAD-T 1
• Jeannie Gonzales, ATC
• Jeneva Gonzales
• Jennifer Barba Gonzales, PA-C
• Jennilyn Gonzales

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, 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 Feb 22, 2016; 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.