Provider Demographics
NPI:1972120863
Name:HUGO GONZALES THERAPY, INC
Entity Type:Organization
Organization Name:HUGO GONZALES THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-778-4757
Mailing Address - Street 1:2529 REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2207
Mailing Address - Country:US
Mailing Address - Phone:510-778-4757
Mailing Address - Fax:510-778-4757
Practice Address - Street 1:3150 HILLTOP MALL RD STE 4
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1921
Practice Address - Country:US
Practice Address - Phone:510-375-0813
Practice Address - Fax:510-758-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty