Healthcare Provider Details
I. General information
NPI: 1982979290
Provider Name (Legal Business Name): ERIKA I GONZALEZ-DELACRUZ PPSC - 240063620
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2012
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12623 AVENUE 416
OROSI CA
93647-2017
US
IV. Provider business mailing address
12623 AVENUE 416
OROSI CA
93647-2017
US
V. Phone/Fax
- Phone: 559-679-2108
- Fax:
- Phone: 559-528-4763
- Fax: 559-528-3132
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | 240063620 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: