Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 522 | CA |
N | 101YM0800X | Mental Health Counselor | 7258 | CA |
Y | 101YP2500X | Professional Counselor | 7731 | CA |
NPI | 1003178484 |
---|---|
Provider Name | Maria Patricia Gallegos |
First Address | San Bernardino, CA 92408-3436 |
Second Address | San Bernardino, CA 92408-3436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 02/04/2020 |