Provider Demographics
NPI:1982297362
Name:GONZALEZ, ALEJANDRO J
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:J
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 NW ISLAND CIR APT B5
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8530
Mailing Address - Country:US
Mailing Address - Phone:408-781-3840
Mailing Address - Fax:
Practice Address - Street 1:380 NW ISLAND CIR APT B5
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8530
Practice Address - Country:US
Practice Address - Phone:408-781-3840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst