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General NPI Number Information
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NPI Number | 1336702588
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Entity Type | Individual
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Provider Name | AUNDREA GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 10730 RIDGEBROOK DR
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City | RENO
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State | NV
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Zip | 89521-8333
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Country | US
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Telephone | 775-360-8389
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Fax | 866-936-1617
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Provider Business Mailing Address
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Address Line | 59 DAMONTE RANCH PKWY # B-321
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City | RENO
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State | NV
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Zip | 89521-1907
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Country | US
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Telephone | 775-360-8389
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Fax | 866-936-1617
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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