Healthcare Provider Details

I. General information

NPI: 1366362915
Provider Name (Legal Business Name): ALEJANDRA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E ARROW HWY
POMONA CA
91767-2535
US

IV. Provider business mailing address

435 E LA VERNE AVE
POMONA CA
91767-2807
US

V. Phone/Fax

Practice location:
  • Phone: 909-624-1233
  • Fax:
Mailing address:
  • Phone: 323-945-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number25517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: