Provider Demographics
NPI:1508045576
Name:GONZALEZ, PAULA MARIE (MS CCC SLP)
Entity Type:Individual
Prefix:MISS
First Name:PAULA
Middle Name:MARIE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS CCC SLP
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 145
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-0145
Mailing Address - Country:US
Mailing Address - Phone:760-917-3602
Mailing Address - Fax:
Practice Address - Street 1:2875 COTTINGHAM ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3734
Practice Address - Country:US
Practice Address - Phone:760-917-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13770235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist