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General NPI Number Information
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NPI Number | 1497633051
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Entity Type | Individual
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Provider Name | ANTHONY GOUGE PPS
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Gender | Male
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 4600 BLACKROCK DR
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City | SACRAMENTO
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State | CA
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Zip | 95835-1250
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Country | US
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Telephone | 916-928-5353
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19055
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City | SACRAMENTO
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State | CA
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Zip | 95819-0055
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Country | US
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Telephone | 916-821-4645
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 220002073
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License Number State | CA
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