MEDICARE: ELIZABETH GONZALEZ

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
1	103TS0200X	School Psychologist		CA

General Provider Information

NPI Number	:	1326981820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GONZALEZ

Provider Business Mailing Address
First Line	:	2822 AZEVEDO DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-1432
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 CLUB CENTER DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95835-1649
Country	:	US
Telephone Number	:	916-567-5730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ ELIZABETH GONZALEZ ” Practice Location

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