Healthcare Provider Details

I. General information

NPI: 1154217826
Provider Name (Legal Business Name): VALERIE D GONZALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 N B ST STE E
SACRAMENTO CA
95811-0326
US

IV. Provider business mailing address

1103 N B ST STE E
SACRAMENTO CA
95811-0326
US

V. Phone/Fax

Practice location:
  • Phone: 916-378-8266
  • Fax:
Mailing address:
  • Phone: 916-378-8266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: