Healthcare Provider Details

I. General information

NPI: 1366818676
Provider Name (Legal Business Name): PERLA GONZALEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PERLA PARRA LCSW

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 11/15/2023
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WIBLE RD STE 14
BAKERSFIELD CA
93304-4734
US

IV. Provider business mailing address

2400 WIBLE RD STE 14
BAKERSFIELD CA
93304-4734
US

V. Phone/Fax

Practice location:
  • Phone: 661-835-1240
  • Fax: 661-835-4667
Mailing address:
  • Phone: 661-835-1240
  • Fax: 661-835-4667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number93133
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: