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General NPI Number Information
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NPI Number | 1942970546
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Entity Type | Individual
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Provider Name | NANIECE DREAMER GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 5473 KEARNY VILLA RD
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City | SAN DIEGO
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State | CA
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Zip | 92123-1150
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Country | US
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Telephone | 619-859-6270
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Fax |
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Provider Business Mailing Address
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Address Line | 5473 KEARNY VILLA RD STE 300
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City | SAN DIEGO
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State | CA
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Zip | 92123-1142
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Country | US
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Telephone | 619-846-3243
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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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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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