Most Relevant Information
Provider Data
| NPI Number: | 1003406224 |
| Provider Name: | BROOKLYN GONZALEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/21/2021 |
| Last Updated: | 01/21/2021 |
Provider Practice Location
3878 RUFFIN RD STE B
SAN DIEGO
CA
921231842
Practice Location Phone/Fax
| Phone: | 6197959925 |
| Fax: |
Provider Mailing Location
8885 RIO SAN DIEGO DR STE 340
SAN DIEGO
CA
921081669
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |