Provider Demographics
NPI:1730410705
Name:GONZALES, EVA PATRICIA LONG (BS, MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:PATRICIA LONG
Last Name:GONZALES
Suffix:
Gender:F
Credentials:BS, MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4750
Mailing Address - Country:US
Mailing Address - Phone:530-320-7486
Mailing Address - Fax:
Practice Address - Street 1:2085 OVERHILL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4750
Practice Address - Country:US
Practice Address - Phone:530-320-7486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53479106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist