Jessica Gonzalez
Rehabilitation Practitioner in Los Angeles, CA. Individual provider (NPI-1).
NPI number1619709961
StatusActive
Last updated in NPPESAug 15, 2024
Details
- NPI
- 1619709961
- Entity type
- Individual (NPI-1)
- Name
- Jessica Gonzalez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 15, 2024
- Certification date
- Aug 15, 2024
- Last updated
- Aug 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
| 106S00000X | Behavior Technician | – | – |
Practice location
2121 W Temple StLos Angeles, CA 90026-4915
Phone 323-308-8003
Mailing address
2121 W Temple StLos Angeles, CA 90026-4915
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