Provider Demographics
NPI:1275652257
Name:ACOSTA, GABRIELA (50463 LMFT)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:50463 LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2162 AVENIDA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-1779
Mailing Address - Country:US
Mailing Address - Phone:661-510-9392
Mailing Address - Fax:
Practice Address - Street 1:44444 20TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2714
Practice Address - Country:US
Practice Address - Phone:661-951-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health