Provider Demographics
NPI:1912037474
Name:GONZALEZ, MARIA ESPERANZA (MA, MFT INTERN)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ESPERANZA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MA, MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 E 116TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-2914
Mailing Address - Country:US
Mailing Address - Phone:562-286-4514
Mailing Address - Fax:
Practice Address - Street 1:1303 W WALNUT PKWY
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-5030
Practice Address - Country:US
Practice Address - Phone:310-868-5379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51023106H00000X
CAIMF46325106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist