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NPI Code Detail

MEDICARE: MR. DREW LAWRENCE GONZALES

MEDICARE: MR. DREW LAWRENCE GONZALES
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
1171M00000XCase Manager/Care CoordinatorCA
2101YA0400XAddiction (Substance Use Disorder) CounselorR1606820425CA

General Provider Information

NPI Number : 1952251316
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DREW LAWRENCE GONZALES
Provider Business Mailing Address
First Line : 9211 LOS OLIVOS CIR
Second Line :
City : ATASCADERO
State : CA
Zip : 93422-8887
Country : US
Telephone Number : 559-909-2844
Fax Number :
Provider Business Practice Location Address
First Line : 2180 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4558
Country : US
Telephone Number : 805-781-4850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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