person
Ethan J Gonsalves, RADT
Addiction (Substance Use Disorder) Counselor in San Luis Obispo, California
NPI 1053035402

Ethan J Gonsalves is an Addiction (Substance Use Disorder) Counselor based in San Luis Obispo, CA and is specialized in Addiction (Substance Use Disorder). Ethan J Gonsalves practices in San Luis Obispo, CA and has the professional credentials of RADT. The NPI Number for Ethan J Gonsalves is 1053035402 and holds a License No. R1475210722 (California).

The current practice location address for Ethan J Gonsalves is 34 Prado, San Luis Obispo, CA and can be reached out via phone at 805-519-1405.

Location: 34 Prado, San Luis Obispo, CA, 93401
person
Provider Profile Details
NPI Number
1053035402
Provider Name
Ethan J Gonsalves
Credential
RADT
Provider Entity Type
Individual
Gender
Male
Address
34 Prado, San Luis Obispo, CA, 93401
Phone Number
805-519-1405
Fax Number
Provider Enumeration Date
09/29/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
34 Prado
City
State
Zip
93401
Phone Number
805-519-1405
Fax Number
person
Provider Business Mailing Address Details
Address
34 Prado
City
State
Zip
93401
Phone Number
805-519-1405
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
R1475210722 (California)
Definition
Definition to come...
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