Individual
CELEBRITY BLOCKTON-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
7903 ELM AVE APT 33, RANCHO CUCAMONGA, CA 91730-6868
(707) 816-8323
Mailing address
7903 ELM AVE APT 33, RANCHO CUCAMONGA, CA 91730-6868
(707) 816-8323
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
114895
CA
101YM0800X
Mental Health Counselor
Primary
9924
CA
106H00000X
Marriage & Family Therapist
131371
CA
Other
Enumeration date
02/23/2018
Last updated
10/02/2022
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