Individual
DR. CLARISSA GONZALEZ-IDIART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
23370 ROAD 22, CHOWCHILLA, CA 93610-8504
(559) 665-5531
Mailing address
23370 ROAD 22, CHOWCHILLA, CA 93610-8504
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417318569
CDCR
CA
Enumeration date
04/06/2016
Last updated
04/06/2016
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