Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 103G00000X | Clinical Psychologist | ||
Y | 103TC0700X | Clinical Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1194311985 |
---|---|
Provider Name | Monserrat Gonzalez Ruiz |
First Address | Modesto, CA 95355-2689 |
Second Address | Modesto, CA 95355-2689 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2020 |
Last Update Date | 15/12/2020 |