Provider Demographics
NPI:1114475662
Name:NAROG, EMILY GONZALEZ
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:GONZALEZ
Last Name:NAROG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9452 TELEPHONE RD STE 361
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2600
Mailing Address - Country:US
Mailing Address - Phone:805-452-3304
Mailing Address - Fax:
Practice Address - Street 1:1158 CARLSBAD PL
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5826
Practice Address - Country:US
Practice Address - Phone:805-452-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104333106H00000X
CA132300106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor