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Mr. Henry Antonio Gonzalez
Addiction (Substance Use Disorder) Counselor in San Rafael, California
NPI 1811278583

Henry Antonio Gonzalez is an Addiction (Substance Use Disorder) Counselor based in San Rafael, CA and is specialized in Addiction (Substance Use Disorder). Henry Antonio Gonzalez practices in San Rafael, CA. The NPI Number for Henry Antonio Gonzalez is 1811278583 and holds a License No. 12938 (California).

The current practice location address for Henry Antonio Gonzalez is 603 D St, San Rafael, CA and can be reached out via phone at 415-454-9444.

Location: 603 D St, San Rafael, CA, 94901-3719
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811278583
Provider Name
Henry Antonio Gonzalez
Credential
Provider Entity Type
Individual
Gender
Male
Address
603 D St, San Rafael, CA, 94901-3719
Phone Number
415-454-9444
Fax Number
Provider Enumeration Date
09/07/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101YA041X 01 CA SUBSTANCE ABUSE
institution
Provider Business Practice Location Address Details
Address
603 D St
City
San Rafael
State
California
Zip
94901-3719
Phone Number
415-454-9444
Fax Number
person
Provider Business Mailing Address Details
Address
603 D St
City
San Rafael
State
California
Zip
94901-3719
Phone Number
415-454-9444
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
12938 (Indiana)
Definition
Definition to come...
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