Provider Demographics
NPI:1346436540
Name:GONZALEZ, BEATRIZ (MS)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 E IMPERIAL HWY
Mailing Address - Street 2:2ND FLOOR SUITE 220
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2659
Mailing Address - Country:US
Mailing Address - Phone:916-388-6372
Mailing Address - Fax:916-388-6321
Practice Address - Street 1:3680 E. IMPERIAL HWY.
Practice Address - Street 2:2ND FLOOR SUITE #220
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3805
Practice Address - Country:US
Practice Address - Phone:916-388-6372
Practice Address - Fax:916-388-6321
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-2633765OtherMEDICAL