Individual
AMY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10421 SAN JOSE AVE, SOUTH GATE, CA 90280-5834
(323) 509-9496
Mailing address
10421 SAN JOSE AVE, SOUTH GATE, CA 90280-5834
(323) 509-9496
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11937581
CA
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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