MEDICARE: SEBASTIAN G 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	373H00000X	Day Training/Habilitation Specialist		CA

General Provider Information

NPI Number	:	1679416879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEBASTIAN G GONZALEZ

Provider Business Mailing Address
First Line	:	1822 W AVENUE K9
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-6291
Country	:	US
Telephone Number	:	661-974-6933
Fax Number	:

Provider Business Practice Location Address
First Line	:	23501 CINEMA DR STE 200
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-5430
Country	:	US
Telephone Number	:	661-288-4800
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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