Provider Demographics
NPI:1124886809
Name:GONZALEZ, ALICIA ARACELI (MSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ARACELI
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 S L ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-1519
Mailing Address - Country:US
Mailing Address - Phone:805-815-8630
Mailing Address - Fax:
Practice Address - Street 1:1500 CAMINO DEL SOL STE 1
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3725
Practice Address - Country:US
Practice Address - Phone:805-604-5437
Practice Address - Fax:805-307-2595
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAASW973791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator