Individual
MARTHA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHIATRIC TECH
Contact information
Practice address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
(909) 865-9281
Mailing address
850 E FOOTHILL BLVD, RIALTO, CA 92376-5230
(909) 421-9309
(909) 421-9219
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT34747
CA
167G00000X
Licensed Psychiatric Technician
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Other
Enumeration date
12/30/2016
Last updated
11/11/2024
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