Individual
JOSE LUIS GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
299 12TH ST STE A, MARINA, CA 93933-6003
(831) 647-7652
Mailing address
299 12TH ST STE A, MARINA, CA 93933-6003
(831) 647-7652
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
06/23/2021
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