Maria Elena Gallegos

Individual provider Active NPI Marriage & Family Therapist · Watts, CA

NPI 1871787119 · NPPES record last updated Feb 22, 2016

Key facts

NPI
1871787119
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
79398 (CA)
Practice address
10221 Compton Ave
104 &203
Watts, CA 90002-2802
Phone
(213) 385-5100
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
79398CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X 79398 CA Yes

Addresses

Primary practice location

10221 Compton Ave
104 &203
Watts, CA 90002-2802

Mailing address

10221 Compton Ave
Suite 104 and 203
Watts, CA 90002-2802
Phone (323) 249-2950

Other providers in Watts, CA

All providers in Watts, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.