Individual
LESLIE IRAZOQUE-GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 E GILBERT ST, SAN BERNARDINO, CA 92415-3919
(909) 387-7200
(909) 387-7717
Mailing address
28673 BERWICK LN, HIGHLAND, CA 92346-5766
(909) 232-7200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
09/25/2013
Last updated
04/16/2025
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