Provider Demographics
NPI:1164818241
Name:GONZALEZ, JESSICA IRENE (MS SCHOOL COUNSELING)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:IRENE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS SCHOOL COUNSELING
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 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-868-6601
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:2621 OSWELL ST
Practice Address - Street 2:SUITE #119
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3172
Practice Address - Country:US
Practice Address - Phone:661-868-6949
Practice Address - Fax:661-872-3001
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker