Individual provider Active NPI

Deborah Gonzalez-Poole, MA, LMFT

  • Marriage & Family Therapist
  • San Pedro, CA
National Provider Identifier
1700344736
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
128541 Issued in CA
Practice address
3618 S Carolina St
San Pedro, CA 90731-6927
Phone
(562) 261-6143
NPI assigned
Mar 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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 128541 CA Primary

Addresses

Primary practice location

3618 S Carolina St
San Pedro, CA 90731-6927

Mailing address

3618 S Carolina St
San Pedro, CA 90731-6927
Phone (562) 261-6143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 23, 2024 through Jan 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
128541CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Family Centered Services Inc. PastSince Oct 1, 2020 Accepting new patients

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": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1700344736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 S CAROLINA ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316927",
            "telephone_number": "562-261-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 S CAROLINA ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316927",
            "telephone_number": "562-261-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-POOLE",
        "first_name": "DEBORAH",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "128541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

Verify at the official NPI Registry.