Active NPI
Gabriela R Teresa, LMFT
- Marriage & Family Therapist
- Azusa, CA
National Provider Identifier
1699348532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 134888
- Practice address
- 819 N San Gabriel Ave
Azusa, CA 91702-2530 - Phone
- (626) 484-6514
- NPI assigned
- Jul 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 134888 | CA | Primary |
Addresses
Primary practice location
819 N San Gabriel Ave
Azusa, CA 91702-2530
Mailing address
819 N San Gabriel Ave
Azusa, CA 91702-2530
Phone (626) 484-6514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134888 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1699348532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 N SAN GABRIEL AVE",
"city": "AZUSA",
"state": "CA",
"postal_code": "917022530",
"telephone_number": "626-484-6514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 N SAN GABRIEL AVE",
"city": "AZUSA",
"state": "CA",
"postal_code": "917022530",
"telephone_number": "626-484-6514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERESA",
"first_name": "GABRIELA",
"middle_name": "R",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-19",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "134888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azusa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.