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NPI Code Detail

MEDICARE: MS. SANDRA L GONZALES SAA

MEDICARE: MS. SANDRA L GONZALES SAA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor0124031NM

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 : 1932207263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA L GONZALES SAA
Provider Business Mailing Address
First Line : 1311 N GRANT ST STE A
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-5134
Country : US
Telephone Number : 575-388-1447
Fax Number : 575-388-1447
Provider Business Practice Location Address
First Line : 1311 N GRANT ST STE A
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-5134
Country : US
Telephone Number : 575-388-1447
Fax Number : 575-388-1447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 01/04/2024

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Directions to “ MS. SANDRA L GONZALES SAA” Practice Location

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