Individual provider Active NPI

Maribel Gonzalez

  • Marriage & Family Therapist
  • Calabasas, CA
National Provider Identifier
1790160042
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT115143 Issued in CA
Practice address
26585 Agoura Rd Ste 330
Calabasas, CA 91302-1958
Phone
(310) 301-7396
Fax
(310) 828-5165
NPI assigned
Jul 28, 2015
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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 LMFT115143 CA Primary

Addresses

Primary practice location

26585 Agoura Rd Ste 330
Calabasas, CA 91302-1958

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

26585 Agoura Rd Ste 360
Calabasas, CA 91302-1958
Phone (103) 017-3963

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
I20240126004186 CA Practitioner - Marriage and Family Therapist 4880047711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of California Los AngelesGroup PAC ID 4587857727, 84 clinicians

Practice addresses (Care Compare)

1801 Wilshire Blvd
Santa Monica, CA 90403-5609
Phone (310) 319-5098

20179 W Rinaldi St
Suite 100
Porter Ranch, CA 91326-4935
Phone (310) 301-7396

26585 Agoura Rd
Calabasas, CA 91302-1958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT115143CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Los Angeles CurrentSince Jan 1, 2024 Accepting new patients

Locations

26585 Agoura Rd
Ste 330
Calabasas, CA 91302
Phone (818) 461-3321

26585 Agoura Rd
Ste 360
Calabasas, CA 91302
Phone (310) 825-2631

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

1801 Wilshire Blvd
Santa Monica, CA 90403
Phone (310) 319-5098

2001 Santa Monica Blvd
Ste 860W
Santa Monica, CA 90404
Phone (310) 586-9097

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1790160042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26585 AGOURA RD STE 330",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021958",
            "telephone_number": "310-301-7396",
            "fax_number": "310-828-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26585 Agoura Rd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Calabasas",
            "state": "CA",
            "postal_code": "913021958",
            "country_code": "US",
            "telephone_number": "103-017-3963",
            "fax_number": "310-828-5165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARIBEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT115143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.