Provider Demographics
NPI:1720393432
Name:GONZALES, PATRICIA LEONE (BA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LEONE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:LEONE
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:66288 AVENIDA DORADO
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-1727
Mailing Address - Country:US
Mailing Address - Phone:714-606-6160
Mailing Address - Fax:
Practice Address - Street 1:84105 COLIBRI CT
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-2971
Practice Address - Country:US
Practice Address - Phone:714-606-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health