Provider Demographics
NPI:1275307217
Name:ALONZO-GATTI, MARY ROSE (AMFT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ROSE
Last Name:ALONZO-GATTI
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:ISABELLA
Other - Middle Name:
Other - Last Name:ALONZO-GATTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AMFT
Mailing Address - Street 1:14016 BORA BORA WAY APT 202
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6812
Mailing Address - Country:US
Mailing Address - Phone:347-327-2737
Mailing Address - Fax:
Practice Address - Street 1:24306 BELFORD CT
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-5278
Practice Address - Country:US
Practice Address - Phone:323-842-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141470106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist