Healthcare Provider Details

I. General information

NPI: 1982233540
Provider Name (Legal Business Name): DULCE MARIA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DULCE MARIA GONZALEZ-MEJIA

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8606 COMET ST
RANCHO CUCAMONGA CA
91730-4220
US

IV. Provider business mailing address

8606 COMET ST
RANCHO CUCAMONGA CA
91730-4220
US

V. Phone/Fax

Practice location:
  • Phone: 909-358-0413
  • Fax:
Mailing address:
  • Phone: 909-358-0413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number22776
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberR1368561019
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: