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General NPI Number Information
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NPI Number | 1689111791
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Entity Type | Individual
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Provider Name | JULIA ISABEL GONZALEZ PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 867 AVE. MUNOZ RIVERA EDIF VICK CENTERSUITE 206-D
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City | SAN JUAN
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State | PR
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Zip | 00925
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Country | US
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Telephone | 939-257-2973
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Fax |
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Provider Business Mailing Address
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Address Line | 370 CALLE 10 ANDREA'S COURT APT.7
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-447-0510
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5675
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License Number State | PR
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