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General NPI Number Information
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NPI Number | 1033770367
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Entity Type | Individual
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Provider Name | JUAN ANTONIO LOERA GONZALEZ LPCC 16813
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Gender | Male
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1055 W HENDERSON AVE STE 2
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City | PORTERVILLE
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State | CA
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Zip | 93257-1490
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Country | US
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Telephone | 559-788-1200
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Fax | 559-713-3717
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Provider Business Mailing Address
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Address Line | 1768 CLEARWATER ST
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City | TULARE
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State | CA
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Zip | 93274-7472
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Country | US
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Telephone | 559-202-6189
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6611
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6611
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16813
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License Number State | CA
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