Provider Demographics
NPI:1780237164
Name:GATEWOOD, AURA LYNN (AMFT)
Entity type:Individual
Prefix:MS
First Name:AURA
Middle Name:LYNN
Last Name:GATEWOOD
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 CORDELL CT STE 101
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-0915
Mailing Address - Country:US
Mailing Address - Phone:619-448-9700
Mailing Address - Fax:619-448-9711
Practice Address - Street 1:1870 CORDELL CT STE 101
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-0915
Practice Address - Country:US
Practice Address - Phone:619-448-9700
Practice Address - Fax:619-448-9711
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT144960106H00000X
CARBT-18-61659106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist