MEDICARE: BEATRIZ ADRIANA GONZALEZ SUBSTANCE ABUSE

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	171M00000X	Case Manager/Care Coordinator
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1437038908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ ADRIANA GONZALEZ SUBSTANCE ABUSE

Provider Business Mailing Address
First Line	:	4080 LEMON ST FL 7
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92501-3609
Country	:	US
Telephone Number	:	951-955-0234
Fax Number	:	951-955-0234

Provider Business Practice Location Address
First Line	:	83912 AVENUE 45 STE A
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-7351
Country	:	US
Telephone Number	:	760-347-0754
Fax Number	:

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

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	01/06/2026

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