Healthcare Provider Details

I. General information

NPI: 1750405296
Provider Name (Legal Business Name): LUCIA CATALINA GONZALEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 12/01/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 W GARVEY AVE N
WEST COVINA CA
91790-2139
US

IV. Provider business mailing address

2841 LEOPOLD AVE
HACIENDA HEIGHTS CA
91745-5428
US

V. Phone/Fax

Practice location:
  • Phone: 626-960-4844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW 22685
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: