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General NPI Number Information
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NPI Number | 1528662525
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Entity Type | Individual
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Provider Name | IRENE FRANCES GONZALES RAC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 201 D ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5952
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Country | US
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Telephone | 530-237-1715
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Fax | 530-742-7642
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Provider Business Mailing Address
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Address Line | 201 D ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5952
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Country | US
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Telephone | 530-742-7747
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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