Provider Demographics
NPI:1386528156
Name:GONZALEZ, ALEXIS (PPS)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 N OAKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-7832
Mailing Address - Country:US
Mailing Address - Phone:559-737-8533
Mailing Address - Fax:
Practice Address - Street 1:1695 BELLA OAKS DR
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-6268
Practice Address - Country:US
Practice Address - Phone:559-331-4737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230155871103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool