MEDICARE: ESMERALDA 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
2	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1861242331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESMERALDA GONZALEZ

Provider Business Mailing Address
First Line	:	117 N R ST STE 101
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-4465
Country	:	US
Telephone Number	:	559-363-8632
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 N R ST STE 101
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-4465
Country	:	US
Telephone Number	:	559-363-8632
Fax Number	:

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

Provider Enumeration Date	:	03/26/2024
Last Update Date	:	12/19/2025

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Directions to “ ESMERALDA GONZALEZ ” Practice Location

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