Healthcare Provider Details

I. General information

NPI: 1508159955
Provider Name (Legal Business Name): LUIS ANGEL GONZALEZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 JEFFERSON ST
NAPA CA
94559-3236
US

IV. Provider business mailing address

PO BOX 4342
NAPA CA
94558-0434
US

V. Phone/Fax

Practice location:
  • Phone: 707-341-6356
  • Fax: 707-425-9880
Mailing address:
  • Phone: 707-341-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: