Healthcare Provider Details

I. General information

NPI: 1750679551
Provider Name (Legal Business Name): RUBEN G GONZALEZ BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 HOOD FRANKLIN RD, HOOD, CA 95639, US
HOOD CA
95639
US

IV. Provider business mailing address

PO BOX 24
HOOD CA
95639-0024
US

V. Phone/Fax

Practice location:
  • Phone: 916-955-8250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89663
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: