Luz Amalya Gonzalez, CSAC, RESIDENT IN CO

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710102137 Issued in VA

Practice address

120 Falcon Dr
Suite 6
Fredericksburg, VA 22408-1900

Phone

(540) 479-2064

NPI assigned

Apr 5, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1659804797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42178",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224042178",
            "telephone_number": "540-479-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FALCON DR",
            "address_2": "SUITE 6",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224081900",
            "telephone_number": "540-479-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LUZ",
        "middle_name": "AMALYA",
        "credential": "CSAC, RESIDENT IN CO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DON'T HAVE",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN NETWORK PROVIDER",
            "identifier": "DON'T HAVE NEW",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edith Socorro Gonzalez Jaimes, D.D.S.
• Irma Gonzalez Medrano, RBT
• Conrado C Gonzalez Jr., MD
• Evan Gonzalez, PA-C
• Jonathan Kenneth Gonzalez, MD
• Mkiyah Teleza Gonzalez, N.P
• Odalys Gonzalez, FNP
• Hunter Carlisle Goode, RPH
• Allison H Goodlett, M.D.
• Charles Alexander Goodwin, PT

• Addiction (Substance Use Disorder) Counselor in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.