Provider Demographics
NPI:1588424808
Name:GONZALES, GABRIELA (MS)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:GONZALES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1507
Mailing Address - Country:US
Mailing Address - Phone:909-963-8948
Mailing Address - Fax:
Practice Address - Street 1:1321 GRAND AVE
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1507
Practice Address - Country:US
Practice Address - Phone:909-963-8948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst