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General NPI Number Information
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NPI Number | 1164669248
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Entity Type | Individual
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Provider Name | MADELEINE GONZALEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 11701 S LA CIENEGA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90045-6260
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Country | US
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Telephone | 213-507-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 9625 MAPLEWOOD ST
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City | BELLFLOWER
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State | CA
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Zip | 90706-3048
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Country | US
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Telephone | 562-279-6250
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 76090
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License Number State | CA
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