Provider Demographics
NPI:1356552228
Name:GONZALEZ, LUZ M
Entity type:Individual
Prefix:MS
First Name:LUZ
Middle Name:M
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 1:711 N COURT ST STE B
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-3638
Mailing Address - Country:US
Mailing Address - Phone:559-627-1490
Mailing Address - Fax:559-737-4318
Practice Address - Street 1:711 N COURT ST STE B
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-3638
Practice Address - Country:US
Practice Address - Phone:559-627-1490
Practice Address - Fax:559-737-4318
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT118235106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist