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NPI Code Detail

MEDICARE: DR. JAMIELYNN GONZALES DSW, LCSW, FSW

MEDICARE: DR. JAMIELYNN GONZALES DSW, LCSW, FSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI-07502NM
2174400000XSpecialistNM
3104100000XSocial WorkerM-06869NM
41041C0700XClinical Social WorkerC-07502NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326371782
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMIELYNN GONZALES DSW, LCSW, FSW
Provider Business Mailing Address
First Line : 3736 EUBANK BLVD NE STE B1
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3583
Country : US
Telephone Number : 505-382-1578
Fax Number :
Provider Business Practice Location Address
First Line : 3736 EUBANK BLVD NE STE B1
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-3583
Country : US
Telephone Number : 505-382-1578
Fax Number : 888-506-2110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2009
Last Update Date : 09/29/2025

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Directions to “ DR. JAMIELYNN GONZALES DSW, LCSW, FSW” Practice Location

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