Provider Demographics
NPI:1952069494
Name:GONZALEZ, ARIEL IRIS
Entity Type:Individual
Prefix:MISS
First Name:ARIEL
Middle Name:IRIS
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 1:6595 CORDOBA RD APT 6
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-4853
Mailing Address - Country:US
Mailing Address - Phone:559-365-3606
Mailing Address - Fax:
Practice Address - Street 1:106 JUANA MARIA AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2714
Practice Address - Country:US
Practice Address - Phone:805-963-5021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health