| Doctor Name: | DR. JORGE R. GONZALEZ |
| NPI Number: | 1528215472 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PSY 19965 |
| Business Practice Address: | 23370 Rd 22 Chowchilla, CA - 936101501 |
| Business Phone Number: | 5596655531 |
| Business Fax Number: | |
| Mailing Address: | 23370 Rd 22, P.o. Box 1501 CHOWCHILLA |
| State: | CA |
| Postal Code: | 936101501 |
| Phone Number: | 5596655531 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2008 |
| NPI Last Update Date: | 03/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | PSY 19965 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |