Provider Demographics
NPI:1073172391
Name:GONZALEZ, CARLOS HECTOR
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:HECTOR
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 TORENA WAY
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6097
Mailing Address - Country:US
Mailing Address - Phone:818-813-0827
Mailing Address - Fax:
Practice Address - Street 1:2100 TORENA WAY
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6097
Practice Address - Country:US
Practice Address - Phone:818-813-0827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst