Provider Demographics
NPI:1295276392
Name:PASTOR, GABRIELA INES (LMFT)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:INES
Last Name:PASTOR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13200 PACIFIC PROMENADE APT 450
Mailing Address - Street 2:
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2155
Mailing Address - Country:US
Mailing Address - Phone:832-366-4965
Mailing Address - Fax:
Practice Address - Street 1:11022 SANTA MONICA BLVD STE 250
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7573
Practice Address - Country:US
Practice Address - Phone:832-366-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98647106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist