Healthcare Provider Details

I. General information

NPI: 1124886809
Provider Name (Legal Business Name): ALICIA ARACELI GONZALEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 07/11/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CAMINO DEL SOL STE 1
OXNARD CA
93030-3725
US

IV. Provider business mailing address

1222 S L ST
OXNARD CA
93033-1519
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-5437
  • Fax: 805-307-2595
Mailing address:
  • Phone: 805-815-8630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW97379
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: