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General NPI Number Information
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NPI Number | 1174135974
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Entity Type | Individual
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Provider Name | VALO GONZALEZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 1670 E 120TH ST BLDG 14
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City | LOS ANGELES
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State | CA
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Zip | 90059-3026
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Country | US
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Telephone | 424-338-2987
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Fax |
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Provider Business Mailing Address
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Address Line | 208 N CHANDLER AVE
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City | MONTEREY PARK
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State | CA
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Zip | 91754-3504
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Country | US
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Telephone | 228-424-0186
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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 | LCSW123327
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License Number State | CA
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