Healthcare Provider Details

I. General information

NPI: 1235075870
Provider Name (Legal Business Name): MADISON GONZALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 S MOONEY BLVD
VISALIA CA
93277-9396
US

IV. Provider business mailing address

1933 N DIVISADERO ST
VISALIA CA
93291-2406
US

V. Phone/Fax

Practice location:
  • Phone: 559-733-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: