Provider Demographics
NPI:1811690621
Name:GONZALEZ, ANTHONY CRUZ (BCBA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CRUZ
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N BUENA VISTA ST APT 201
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3676
Mailing Address - Country:US
Mailing Address - Phone:213-909-4168
Mailing Address - Fax:
Practice Address - Street 1:325 N BUENA VISTA ST APT 201
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3676
Practice Address - Country:US
Practice Address - Phone:213-909-4168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-25-80107103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst