Provider Demographics
NPI:1528561966
Name:MAURO, ANA PAULA GOMES (MA)
Entity Type:Individual
Prefix:
First Name:ANA PAULA
Middle Name:GOMES
Last Name:MAURO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ANA PAULA
Other - Middle Name:GOMES
Other - Last Name:MAURO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:8851 CONNER DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5078
Mailing Address - Country:US
Mailing Address - Phone:714-585-2977
Mailing Address - Fax:
Practice Address - Street 1:609 9TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-4640
Practice Address - Country:US
Practice Address - Phone:714-585-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105033106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA105033OtherLMFT