Individual
GENNICE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18612 SANTA ANA AVE, BLOOMINGTON, CA 92316-2639
(909) 421-7120
Mailing address
18612 SANTA ANA AVE, BLOOMINGTON, CA 92316-2639
(909) 421-7120
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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