Provider Demographics
NPI:1134944366
Name:LOEZA, ANAGABRIEL
Entity type:Individual
Prefix:
First Name:ANAGABRIEL
Middle Name:
Last Name:LOEZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4165 W 166TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3060
Mailing Address - Country:US
Mailing Address - Phone:310-908-8706
Mailing Address - Fax:
Practice Address - Street 1:24050 MADISON ST STE 217
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6017
Practice Address - Country:US
Practice Address - Phone:424-466-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist