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NPI Code Detail

MEDICARE: FLORENCE MICAELA GONZALES MA, BCBA

MEDICARE: FLORENCE MICAELA GONZALES MA, BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-24-73811CA

General Provider Information

NPI Number : 1093141723
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLORENCE MICAELA GONZALES MA, BCBA
Provider Business Mailing Address
First Line : 1333 S MAYFLOWER AVE STE 220
Second Line :
City : MONROVIA
State : CA
Zip : 91016-5239
Country : US
Telephone Number : 855-295-3276
Fax Number : 888-588-2752
Provider Business Practice Location Address
First Line : 7088 N MAPLE AVE STE 105
Second Line :
City : FRESNO
State : CA
Zip : 93720-0391
Country : US
Telephone Number : 855-295-3276
Fax Number : 888-588-2752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2013
Last Update Date : 07/05/2024

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