Individual
KELLY SUE PACHECO- GAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LPCC
Contact information
Practice address
6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048-5815
(925) 282-1778
Mailing address
6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048-5815
(925) 282-1778
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
17859
CA
101YP2500X
Professional Counselor
Primary
17859
CA
101YP2500X
Professional Counselor
C9686
OR
Other
Enumeration date
10/31/2017
Last updated
04/22/2025
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