Individual provider · Type 1 NPI
Mark Gonzales, LAADC-CA LCI10970318
Addiction (Substance Use Disorder) Counselor · Visalia, CA
NPI number
1619306289
Active
Practice location
4023 W Douglas Ave
Visalia, CA 93291-4185
Other practice locations
- 408 Tennessee St, Vallejo, CA 94590-4453 · (707) 554-2397
- 4023 W Douglas Ave, Visalia, CA 93291-4185 · (510) 691-0474
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5465630291 (CA) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LCI10970318 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1619306289
Mark Gonzales, LAADC-CA LCI10970318's National Provider Identifier is 1619306289, issued on Nov 4, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Visalia, CA. The record was last updated on Mar 7, 2023.