=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699634113
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GLORIA GONZALEZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2026
-----------------------------------------------------
Last Update Date | 01/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 ZANES DR
-----------------------------------------------------
City | PLUMAS LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95961-9090
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-749-0690
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2743 PLUMAS SCHOOL RD
-----------------------------------------------------
City | PLUMAS LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95961-8827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 34796
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------