MEDICARE: BRIANA GONZALEZ LCSW

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	I.2405282	OH
2	1041C0700X	Clinical Social Worker
3	1041C0700X	Clinical Social Worker	97348	CA

General Provider Information

NPI Number	:	1922537323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANA GONZALEZ LCSW

Provider Business Mailing Address
First Line	:	360 DAVIES AVE APT 4
Second Line	:
City	:	WEST HENRIETTA
State	:	NY
Zip	:	14586-8835
Country	:	US
Telephone Number	:	562-702-3288
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 EAST STREET
Second Line	:	PMB 333
City	:	CONCORD
State	:	CA
Zip	:	94520-2126
Country	:	US
Telephone Number	:	562-452-3346
Fax Number	:

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

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	05/27/2025

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