Individual
ADA GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 S BROADWAY, SANTA MARIA, CA 93454-6603
(805) 614-9275
(805) 614-9285
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
81034
CA
1041C0700X
Clinical Social Worker
81034
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-3626059
—
CA
Enumeration date
10/19/2018
Last updated
09/23/2019
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