Healthcare Provider Details

I. General information

NPI: 1932797776
Provider Name (Legal Business Name): AALIYAH REYES GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N COURT ST STE B
VISALIA CA
93291-3638
US

IV. Provider business mailing address

711 N COURT ST STE B
VISALIA CA
93291-3638
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-1490
  • Fax: 844-368-0871
Mailing address:
  • Phone: 559-627-1490
  • Fax: 844-368-0871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW122678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: