MEDICARE: NANCY GONZALEZ

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
1	106H00000X	Marriage & Family Therapist	83134	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	106H00000X	Marriage & Family Therapist	119624	CA
4	106H00000X	Marriage & Family Therapist	LMFT119624	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386086577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY GONZALEZ

Provider Business Mailing Address
First Line	:	15339 SATICOY ST
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91406-3345
Country	:	US
Telephone Number	:	818-267-2682
Fax Number	:

Provider Business Practice Location Address
First Line	:	27200 TOURNEY RD STE 175
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4986
Country	:	US
Telephone Number	:	661-705-4670
Fax Number	:	661-964-3273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2013
Last Update Date	:	05/21/2026

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Directions to “ NANCY GONZALEZ ” Practice Location

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