Individual
ALICE ISABEL MATAGORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 974-0770
Mailing address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 974-0770
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
IMF# 72256
CA
106H00000X
Marriage & Family Therapist
Primary
LMFT87280
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/06/2013
Last updated
06/22/2015
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