MEDICARE: MELISSA GONZALEZ JOSEPH

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	172V00000X	Community Health Worker
2	106S00000X	Behavior Technician
3	171M00000X	Case Manager/Care Coordinator
4	1041C0700X	Clinical Social Worker	ASW138669	CA

General Provider Information

NPI Number	:	1952934085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA GONZALEZ JOSEPH

Provider Business Mailing Address
First Line	:	24353 FIJI DR
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92551-6938
Country	:	US
Telephone Number	:	951-420-9789
Fax Number	:

Provider Business Practice Location Address
First Line	:	3281 E GUASTI RD STE 350
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91761-1236
Country	:	US
Telephone Number	:	877-462-7735
Fax Number	:

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

Provider Enumeration Date	:	02/17/2020
Last Update Date	:	06/01/2026

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Directions to “ MELISSA GONZALEZ JOSEPH ” Practice Location

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