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NPI Code Detail

MEDICARE: MRS. JANICE S GONZALES LBSW

MEDICARE:  MRS. JANICE S GONZALES  LBSW
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
1171M00000XCase Manager/Care Coordinator31249TX

Other Identifiers

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

General Provider Information

NPI Number : 1578691549
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANICE S GONZALES LBSW
Provider Business Mailing Address
First Line : 4100 E PIEDRAS DR
Second Line : SUITE 205
City : SAN ANTONIO
State : TX
Zip : 78228-1401
Country : US
Telephone Number : 210-745-3940
Fax Number : 210-745-3938
Provider Business Practice Location Address
First Line : 4100 E PIEDRAS DR
Second Line : SUITE 205
City : SAN ANTONIO
State : TX
Zip : 78228-1401
Country : US
Telephone Number : 210-745-3940
Fax Number : 210-745-3938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 07/09/2007

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Directions to “ MRS. JANICE S GONZALES LBSW” Practice Location

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