Provider Demographics
NPI:1801290077
Name:GONZALEZ, KARINA M (LMFT)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:M
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:K
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT 115848
Mailing Address - Street 1:500 W FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-3620
Mailing Address - Country:US
Mailing Address - Phone:805-934-6380
Mailing Address - Fax:
Practice Address - Street 1:500 W FOSTER RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-3620
Practice Address - Country:US
Practice Address - Phone:805-934-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist