Provider Demographics
NPI:1912634502
Name:GONZALEZ, KRISTINA MARIE
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
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 1:7400 BLANCO RD STE 250
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4368
Mailing Address - Country:US
Mailing Address - Phone:210-446-8255
Mailing Address - Fax:888-823-3497
Practice Address - Street 1:7400 BLANCO RD STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4368
Practice Address - Country:US
Practice Address - Phone:210-446-8255
Practice Address - Fax:888-823-3497
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor