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NPI Code Detail

MEDICARE: MS. LINDA X GONZALEZ M.A.

MEDICARE: MS. LINDA X GONZALEZ M.A.
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
1225400000XRehabilitation Practitioner117653CA
2106H00000XMarriage & Family Therapist160327CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
195-2633765OTHERCAMEDI-CAL

General Provider Information

NPI Number : 1356740476
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA X GONZALEZ M.A.
Provider Business Mailing Address
First Line : 23701 E EAST FORK RD
Second Line :
City : AZUSA
State : CA
Zip : 91702-1477
Country : US
Telephone Number : 626-910-1202
Fax Number :
Provider Business Practice Location Address
First Line : 23701 E EAST FORK RD
Second Line :
City : AZUSA
State : CA
Zip : 91702-1477
Country : US
Telephone Number : 626-910-1202
Fax Number : 626-910-1380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 02/19/2026

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