Provider Demographics
NPI:1255698734
Name:GONZALEZ, VALERIE ANN (MS, BCBA)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CALLE SOMBRA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6244
Mailing Address - Country:US
Mailing Address - Phone:949-272-6146
Mailing Address - Fax:
Practice Address - Street 1:1007 CALLE SOMBRA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6244
Practice Address - Country:US
Practice Address - Phone:949-272-6146
Practice Address - Fax:888-847-8864
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-9740103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst