Susie Lilliana Gamboa, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

158502 Issued in CA

Practice address

300 N Brand Blvd Ste 170
Glendale, CA 91203-2304

Phone

(909) 453-2984

NPI assigned

Aug 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Mountain Counseling & Training, Inc.

  • Community Health Clinic/Center
  • Crestline, CA
  • NPI 1164739215
  NPD (past)

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1740893353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9173",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924270173",
            "telephone_number": "951-373-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N BRAND BLVD STE 170",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032304",
            "telephone_number": "909-453-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "SUSIE",
        "middle_name": "LILLIANA",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "158502",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "158502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Galvez
• Rochelle Agoncillo Galvez
• Tania Galvez
• Yesenia Star Galvez
• Cristina B Gamboa, D.D.S.
• Madelaine Antonia Gamez, FNP-BC, NP-C
• Gana Hospice, Inc.
• John Vincent Ganal, M.D.
• Nicole Ann Ganal, M.D.
• Devinder S Gandhi, MD

• Marriage & Family Therapist in Glendale, CA
• Providers in Glendale, 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 Aug 14, 2026; 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.