Ponyboy Antonio Gonzales
Behavior Technician in Fresno, CA. Individual provider (NPI-1).
NPI number1053106930
StatusActive
Last updated in NPPESApr 11, 2025
Details
- NPI
- 1053106930
- Entity type
- Individual (NPI-1)
- Name
- Ponyboy Antonio Gonzales
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2025
- Certification date
- Apr 11, 2025
- Last updated
- Apr 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
530 E Herndon Ave Ste 105Fresno, CA 93720-2990
Phone 855-223-7123
Mailing address
Po Box 33568San Diego, CA 92163-3568
Phone 855-223-7123
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