Provider Demographics
NPI:1558723569
Name:GONZALEZ, SASHA SHANTELL (MFTI)
Entity Type:Individual
Prefix:MISS
First Name:SASHA
Middle Name:SHANTELL
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3569 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2607
Mailing Address - Country:US
Mailing Address - Phone:626-453-3399
Mailing Address - Fax:626-453-3398
Practice Address - Street 1:3569 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2607
Practice Address - Country:US
Practice Address - Phone:626-453-3399
Practice Address - Fax:626-453-3398
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health