Provider Demographics
NPI:1235227265
Name:GONZALEZ, CAROLINA ECHEVERRIA
Entity Type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:ECHEVERRIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 E SAN ALANO AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1520
Mailing Address - Country:US
Mailing Address - Phone:714-685-6924
Mailing Address - Fax:
Practice Address - Street 1:12531 HARBOR BLVD STE G
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5824
Practice Address - Country:US
Practice Address - Phone:714-638-5008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)