MEDICARE: GLORIA 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	235Z00000X	Speech-Language Pathologist	34796	CA

General Provider Information

NPI Number	:	1699634113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA GONZALEZ

Provider Business Mailing Address
First Line	:	2743 PLUMAS SCHOOL RD
Second Line	:
City	:	PLUMAS LAKE
State	:	CA
Zip	:	95961-8827
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 ZANES DR
Second Line	:
City	:	PLUMAS LAKE
State	:	CA
Zip	:	95961-9090
Country	:	US
Telephone Number	:	530-749-0690
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ GLORIA GONZALEZ ” Practice Location

Language	Start Address	Practice Location

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