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SUSIE LILLIANA GAMBOA MS AMFT NPI 1740893353


NPI Information

NPI: 1740893353
Provider Name: SUSIE LILLIANA GAMBOA, MS, AMFT
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Individual
Address:
340 HWY 138
CRESTLINE, CA
ZIP 92325
Phone: (909) 336-3330
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Susie Lilliana Gamboa, MS, AMFT is a marriage family therapist in Crestline, CA. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. Susie Lilliana Gamboa, MS, AMFT NPI is 1740893353. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

340 HWY 138
CRESTLINE, CA
ZIP 92325
Phone: (909) 336-3330

The enumeration date for this NPI number is 8/25/2020 and was last updated on 9/9/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care Coordinator119718CALIFORNIANo
2106H00000XMarriage & Family Therapist119718CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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