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NPI 1902741770

NPI 1902741770 : ANDREA WEVER GONZALEZ MS BCBA PPS : ANGELS CAMP, CA

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General NPI Number Information
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    NPI Number           |    1902741770
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREA WEVER GONZALEZ MS BCBA PPS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/20/2026
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    Last Update Date     |    04/20/2026
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Provider Practice Location Address
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    Address Line         |    364 MURPHYS GRADE RD 
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    City                 |    ANGELS CAMP
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    State                |    CA
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    Zip                  |    95222-9133
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    Country              |    US
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    Telephone            |    209-736-8388
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    P.O. BOX 7000/21 
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    City                 |    ANGELS CAMP
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    State                |    CA
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    Zip                  |    95221
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    Country              |    US
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    Telephone            |    209-736-8388
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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        |    103TS0200X
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    Taxonomy Name        |    School Psychologist
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    License Number       |    
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    License Number State |    
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