Alysiana Ileene Gonzales
Peer Specialist in Sacramento, CA. Individual provider (NPI-1).
NPI number1104646512
StatusActive
Last updated in NPPESFeb 6, 2025
Details
- NPI
- 1104646512
- Entity type
- Individual (NPI-1)
- Name
- Alysiana Ileene Gonzales
- Sole proprietor
- Yes
- Enumeration date
- Oct 11, 2024
- Certification date
- Feb 6, 2025
- Last updated
- Feb 6, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
2750 Sutterville RdSacramento, CA 95820-1024
Phone 916-452-3981 · Fax 916-456-4636
Mailing address
2750 Sutterville RdSacramento, CA 95820-1024
Phone 916-452-3981 · Fax 916-456-4636
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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