Provider Demographics
NPI:1659953339
Name:ARATA, GREGORY (LMFT)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:ARATA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 LINDA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-1434
Mailing Address - Country:US
Mailing Address - Phone:917-723-5595
Mailing Address - Fax:
Practice Address - Street 1:3139 LINDA VISTA RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-1434
Practice Address - Country:US
Practice Address - Phone:917-723-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125055106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist