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NPI Code Detail

MEDICARE: ANDREA VALTIERRA-GONGORA MSW

MEDICARE: ANDREA VALTIERRA-GONGORA MSW
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
1171400000XHealth & Wellness CoachCA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1629932447
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA VALTIERRA-GONGORA MSW
Provider Business Mailing Address
First Line : 3800 PIGEON AVE
Second Line :
City : MERCED
State : CA
Zip : 95340-8457
Country : US
Telephone Number : 559-331-1009
Fax Number :
Provider Business Practice Location Address
First Line : 2011 FRESNO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1722
Country : US
Telephone Number : 559-331-1009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 04/21/2026

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