MEDICARE: ANA MARIA AMBRIZ-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	1041C0700X	Clinical Social Worker	96177	CA
2	101Y00000X	Counselor		CA

General Provider Information

NPI Number	:	1750865549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MARIA AMBRIZ-GONZALEZ

Provider Business Mailing Address
First Line	:	10700 MACARTHUR BLVD BLDG 7
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-5298
Country	:	US
Telephone Number	:	510-568-5849
Fax Number	:	510-382-1632

Provider Business Practice Location Address
First Line	:	10700 MACARTHUR BLVD BLDG 7
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-5298
Country	:	US
Telephone Number	:	510-568-5849
Fax Number	:	510-382-1632

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

Provider Enumeration Date	:	09/18/2018
Last Update Date	:	04/02/2026

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