Healthcare Provider Details

I. General information

NPI: 1194631838
Provider Name (Legal Business Name): YVETTE GONZALEZ M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3699 HOLLY AVE
BALDWIN PARK CA
91706-5327
US

IV. Provider business mailing address

3699 HOLLY AVE
BALDWIN PARK CA
91706-5327
US

V. Phone/Fax

Practice location:
  • Phone: 626-962-3311
  • Fax: 626-608-3290
Mailing address:
  • Phone: 626-962-3311
  • Fax: 626-608-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP19176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: