Healthcare Provider Details

I. General information

NPI: 1073446886
Provider Name (Legal Business Name): JULIA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 WILSHIRE BLVD
LOS ANGELES CA
90010-1108
US

IV. Provider business mailing address

3055 WILSHIRE BLVD
LOS ANGELES CA
90010-1108
US

V. Phone/Fax

Practice location:
  • Phone: 213-375-3830
  • Fax:
Mailing address:
  • Phone: 213-375-3830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number140977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: