MEDICARE: AALIYAH REYES 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	104100000X	Social Worker	ASW122678	CA

General Provider Information

NPI Number	:	1932797776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH REYES GONZALEZ

Provider Business Mailing Address
First Line	:	711 N COURT ST STE B
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-3638
Country	:	US
Telephone Number	:	559-627-1490
Fax Number	:	844-368-0871

Provider Business Practice Location Address
First Line	:	711 N COURT ST STE B
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-3638
Country	:	US
Telephone Number	:	559-627-1490
Fax Number	:	844-368-0871

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

Provider Enumeration Date	:	01/07/2021
Last Update Date	:	04/20/2026

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