Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSB94024648 | CA |
Y | 103T00000X | Psychologist | PSB94024648 | CA |
NPI | 1013396142 |
---|---|
Provider Name | Mrs. Christine Ann Gonzales |
First Address | El Monte, CA 91732-2314 |
Second Address | El Monte, CA 91732-2314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2015 |
Last Update Date | 08/02/2019 |