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General NPI Number Information
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NPI Number | 1386551646
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Entity Type | Organization
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Legal Business Name | TINA XIONG GONZALEZ LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 7897 KELVEDON WAY
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City | SACRAMENTO
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State | CA
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Zip | 95829-1452
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Country | US
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Telephone | 209-294-0036
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Fax |
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Provider Business Mailing Address
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Address Line | 5960 S LAND PARK DR # 1063
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City | SACRAMENTO
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State | CA
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Zip | 95822-3313
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Country | US
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Telephone | 209-294-0036
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TINA XIONG GONZALEZ
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Credential | LCSW
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Telephone | 209-294-0036
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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 |
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License Number State |
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