Doctor Name: | PRISCILLA MARIE GONZALEZ |
NPI Number: | 1033475231 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 5628 E Slauson Ave Commerce, CA - 900402922 |
Business Phone Number: | 3234809242 |
Business Fax Number: | 3238329224 |
Mailing Address: | 5628 E Slauson Ave, COMMERCE |
State: | CA |
Postal Code: | 900402922 |
Phone Number: | 3234809242 |
Fax Number: | 3238329224 |
NPI Enumeration Date: | 04/02/2012 |
NPI Last Update Date: | 04/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |