Provider Demographics
NPI:1487079679
Name:SUAREZ, GABRIELA (MFTI)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:SUAREZ
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 1:878 W TOWN AND COUNTRY RD
Mailing Address - Street 2:BLDG# 134
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4712
Mailing Address - Country:US
Mailing Address - Phone:714-954-2911
Mailing Address - Fax:
Practice Address - Street 1:4565 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-1507
Practice Address - Country:US
Practice Address - Phone:562-216-4762
Practice Address - Fax:562-216-4767
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77346101YM0800X
CAIMF77346106H00000X
CA96226106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health