Individual
LISA ROSE ANNE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307
(760) 242-3663
Mailing address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 242-3663
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6723
CA
101YP2500X
Professional Counselor
Primary
9211
CA
Other
Enumeration date
09/26/2012
Last updated
02/16/2021
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