Healthcare Provider Details

I. General information

NPI: 1295172112
Provider Name (Legal Business Name): ALEJANDRA G GONZALEZ TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2013
Last Update Date: 09/26/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 W WOODLAND DR
ANAHEIM CA
92801-2637
US

IV. Provider business mailing address

573 P.O. BOX
LA PUENTE CA
91747
US

V. Phone/Fax

Practice location:
  • Phone: 714-338-1017
  • Fax: 714-426-8161
Mailing address:
  • Phone: 213-819-9162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115390
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: