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General NPI Number Information
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NPI Number | 1013396142
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Entity Type | Individual
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Provider Name | CHRISTINE ANN GONZALES MA
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Gender | Female
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 11920 RAMONA BLVD BLDG 1
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City | EL MONTE
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State | CA
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Zip | 91732-2314
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Country | US
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Telephone | 626-448-5501
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Fax | 626-448-5502
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Provider Business Mailing Address
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Address Line | 11920 RAMONA BLVD BLDG 1
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City | EL MONTE
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State | CA
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Zip | 91732-2314
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Country | US
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Telephone | 626-448-5501
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Fax | 626-448-5502
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSB94024648
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License Number State | CA
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