MARK GONZALES (NPI# 1619306289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619306289 |
| Entity Type | Individual |
| Full Name | MARK GONZALES |
| Credential | LAADC-CA LCI10970318 |
| Practice Address |
4023 W Douglas Ave Visalia CA 93291-4185 |
| Practice Telephone | 5106910474 |
| Mailing Telephone | 5106910474 |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2018-03-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCI10970318 | CA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 5465630291 | CA | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LICENSED ADVANCED ALCOHOL AND DRUG COUNSELOR-CA | LCI10970318 | 01 |
| CA | ADDICTION COUNSELOR CERTIFICATION BOARD OF CALIFORNIA | 168767 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 408 Tennessee St, Vallejo, CA 945904453 | 7075542397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710379342 | Mark Gonzales | Physical Medicine & Rehabilitation | 1101 W 34th St, Suite 635, Austin, TX 78705-1907 | 2015-02-18 |
| 1699178756 | Mark Joseph Gonzales | Specialist/Technologist, Other | 8327 Bent Meadow Dr, Converse, TX 78109-3318 | 2014-10-03 |
| 1699038570 | Mark A. Gonzales | Emergency Medicine | 1001 S George St, York, PA 17403-3676 | 2012-06-16 |
| 1700057130 | Mark Gonzales | Counselor | 3035 Nw 63rd St, 230, Oklahoma City, OK 73116-3632 | 2008-03-13 |
| Street Address |
4023 W DOUGLAS AVE |
| City | VISALIA |
| State | CA |
| Zip Code | 93291-4185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255964854 | Stephanie Janae Ybarra | Orthotist | 5412 Avenida De Los Robles, Suite 101, Visalia, CA 93291 | 2020-02-21 |
| 1689223067 | Patricia Mari Marquez | Technician | 32481 Road 127, Visalia, CA 93291 | 2019-09-09 |
| 1942767710 | Jeremy Clifton Mccallister | Counselor | 120 W. School Ave., Visalia, CA 93291 | 2019-02-27 |
| 1568975290 | Kaweah Delta Health Care District | Clinic/Center | 3600 Flagstaff Avenue, Visalia, CA 93291 | 2017-11-16 |
| 1932625308 | Christina Gonzalez | Counselor | New Hope, 212 N. Stevenson, Visalia, CA 93291 | 2017-08-17 |
| 1629598545 | Estherose Molina | Assistant Behavior Analyst | 5445 W. Sweet Drive, Visalia, CA 93291 | 2017-06-21 |
| 1487195988 | Brenda Rodriguez | Case Manager/Care Coordinator | 546 East Tulare Ave, Visalia, CA 93291 | 2017-03-16 |
| 1295181857 | David James Tsuneji Fujihara | Emergency Medicine | 400 W. Mineral King Ave, Visalia, CA 93291 | 2016-05-12 |
| 1326409343 | Bay Area Surgical Specialists, Inc A Medical Corporation | Pain Medicine | 5127 W Noble Ave, Visalia, CA 93291 | 2016-03-18 |
| 1932585700 | Charles Dominick Trentacosti | Occupational Therapy Assistant | 514 N Bridge St, Visalia, CA 93291 | 2015-08-04 |
| Find all providers in zip 93291 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942767710 | Jeremy Clifton Mccallister | Counselor | 120 W. School Ave., Visalia, CA 93291 | 2019-02-27 |
| 1356839773 | Jay Gabriel Diaz | Counselor | 1646 South Court Street, Visalia, CA 93277 | 2018-05-01 |
| 1194212696 | Turning Point of Central California Inc. | Counselor | 1845 1/2 South Court Street, Visalia, CA 93277 | 2018-04-19 |
| 1679076509 | Courtney Anne Penebaker | Counselor | 1425 East Walnut, Visalia, CA 93292 | 2018-03-16 |
| 1932625308 | Christina Gonzalez | Counselor | New Hope, 212 N. Stevenson, Visalia, CA 93291 | 2017-08-17 |
| 1316308471 | Jeffery White | Counselor | 3107 E Kaweah Ave, Visalia, CA 93292-3309 | 2016-03-16 |
| 1275951931 | Francisco Tomas Ruiz | Counselor | 1845 S Court St, Visalia, CA 93277-5423 | 2014-03-31 |
| 1326390972 | Steve L Cummings | Counselor | 120 W School Ave, Visalia, CA 93291-4925 | 2012-10-05 |
| 1669771739 | Michaele Diane Mckinney | Counselor | Tulare County Hhsa Alcohol & Drug Div., 942 South Santa Fe, Visalia, CA 93292 | 2011-03-15 |
| 1730356288 | Turning Point of Central California Inc | Counselor | 901 N Mooney Blvd, Visalia, CA 93291-3228 | 2008-05-14 |
| Find all providers in VISALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.