Provider Demographics
NPI:1205952934
Name:BRICENO-GONZALEZ, DIANA XOCHITL (BSW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:XOCHITL
Last Name:BRICENO-GONZALEZ
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:XOCHITL
Other - Last Name:DONALDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 WILLIAMS DR. #165
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036
Mailing Address - Country:US
Mailing Address - Phone:805-981-4233
Mailing Address - Fax:805-981-9268
Practice Address - Street 1:1911 WILLIAMS DR. #165
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036
Practice Address - Country:US
Practice Address - Phone:805-981-4233
Practice Address - Fax:805-981-9268
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator