Provider Demographics
NPI:1891992806
Name:GUMBS, KHEA S (MA LMFT)
Entity type:Individual
Prefix:MRS
First Name:KHEA
Middle Name:S
Last Name:GUMBS
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 800325
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-0325
Mailing Address - Country:US
Mailing Address - Phone:209-607-1018
Mailing Address - Fax:510-479-1180
Practice Address - Street 1:PO BOX 800325
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91380-0325
Practice Address - Country:US
Practice Address - Phone:209-607-1018
Practice Address - Fax:510-479-1180
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA149734106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist