Individual
CARMINA VITAL-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
9420 PUTNEY DR, DURHAM, CA 95938-9426
(530) 895-4697
Mailing address
9420 PUTNEY DR, DURHAM, CA 95938-9426
(530) 895-4697
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
180161679
CA
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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