Healthcare Provider Details

I. General information

NPI: 1326248378
Provider Name (Legal Business Name): GEMA MARINA GONZALEZ-MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GEMA MARINA GONZALEZ LCSW

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 02/07/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CALIFORNIA DRIVE
VACAVILLE CA
95687
US

IV. Provider business mailing address

805 RIVERFRONT ST UNIT 209
WEST SACRAMENTO CA
95691-3785
US

V. Phone/Fax

Practice location:
  • Phone: 707-448-6841
  • Fax:
Mailing address:
  • Phone: 916-201-8683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: