Healthcare Provider Details

I. General information

NPI: 1194659649
Provider Name (Legal Business Name): IVAN H GONZALEZ ARROYO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 SUNDALE AVE
BAKERSFIELD CA
93309-7908
US

IV. Provider business mailing address

PO BOX 5182
BAKERSFIELD CA
93388-5182
US

V. Phone/Fax

Practice location:
  • Phone: 661-827-3100
  • Fax:
Mailing address:
  • Phone: 661-398-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number138383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: