Provider Demographics
NPI:1730310293
Name:GALLO, SONYA CELESTINE
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:CELESTINE
Last Name:GALLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:CELESTINE
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT INTERN
Mailing Address - Street 1:21250 BOX SPRINGS RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-8707
Mailing Address - Country:US
Mailing Address - Phone:951-686-3706
Mailing Address - Fax:951-686-7267
Practice Address - Street 1:21250 BOX SPRINGS RD STE 106
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-8707
Practice Address - Country:US
Practice Address - Phone:951-686-3706
Practice Address - Fax:951-686-7267
Is Sole Proprietor?:No
Enumeration Date:2009-08-01
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60692106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist