Provider Demographics
NPI:1629274014
Name:GONZALEZ, KARLA ALEXANDRIA (BA CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ALEXANDRIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BA CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 BALCOM AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-6402
Mailing Address - Country:US
Mailing Address - Phone:818-705-5815
Mailing Address - Fax:
Practice Address - Street 1:6800 OWENSMOUTH AVE STE 310
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-4245
Practice Address - Country:US
Practice Address - Phone:818-347-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator