MEDICARE: JULIA GONSALVES

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	225400000X	Rehabilitation Practitioner
2	372600000X	Adult Companion		CA

General Provider Information

NPI Number	:	1902788599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA GONSALVES

Provider Business Mailing Address
First Line	:	121 DOWNEY AVE
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95354-1208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 DOWNEY AVE
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95354-1208
Country	:	US
Telephone Number	:	209-341-1824
Fax Number	:

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

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	06/03/2026

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Directions to “ JULIA GONSALVES ” Practice Location

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