KELLIE LYNN GONZALEZ (NPI# 1730742263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730742263 |
| Entity Type | Individual |
| Full Name | KELLIE LYNN GONZALEZ |
| Credential | AMFT |
| Practice Address |
590 Antelope Blvd Ste 40b Red Bluff CA 96080-2477 |
| Mailing Address |
Po Box 950 Red Bluff CA 96080-0950 |
| Practice Telephone | 5305299454 |
| Practice Fax Number | 5305299456 |
| Mailing Telephone | 5305299454 |
| Mailing Fax Number | 5305299456 |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 92986 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRIVER LICENSE | D3043190 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2608 Victor Ave, Redding, CA 960021447 | 5307221022 | 5307221058 |
| Street Address |
590 ANTELOPE BLVD STE 40B |
| City | RED BLUFF |
| State | CA |
| Zip Code | 96080-2477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578912408 | Gillian Lilo Prothro | Registered Nurse | 1425 Montgomery St., Red Bluff, CA 96080 | 2016-06-10 |
| 1154739373 | Gisela Vazquez Sandoval | Counselor | 818 Walnut St, Red Bluff, CA 96080 | 2014-07-31 |
| 1215348883 | Courtney Cathleen Coenen | Non-emergency Medical Transport (VAN) | 320 Michael Drive, Red Bluff, CA 96080 | 2014-05-16 |
| 1023451986 | Nhuha Thi Le | Registered Nurse | 1860 B Walnut St, Red Bluff, CA 96080 | 2013-04-10 |
| 1184991580 | Maria Arendina Los | Registered Nurse | 818 Main Street, Tehama County Health Services Agency, Red Bluff, CA 96080 | 2011-11-30 |
| 1558682195 | Metasebia Bekele | Physician Assistant | 1850 Walnut Street, Red Bluff, CA 96080 | 2010-06-17 |
| 1821314238 | Cynthia Louise Funderburk | Nurse's Aide | 1860 B Walnut Street, Red Bluff, CA 96080 | 2010-04-09 |
| 1285865485 | Phillip John Velador Jr. | Licensed Vocational Nurse | 1860b Walnut Street, Red Bluff, CA 96080 | 2009-08-05 |
| 1609010347 | Lori Kay Mccaughey | Registered Nurse | 1860b Walnut St, Red Bluff, CA 96080 | 2009-04-24 |
| 1467668616 | Tehama County Health Services Agency - Mental Health Division | Clinic/Center | 1860 Walnut Street, Suite A, B, D and J, Red Bluff, CA 96080 | 2007-05-15 |
| Find all providers in zip 96080 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553142 | Bethany Vander Dussen | Marriage & Family Therapist | 211 Sherman Dr, Red Bluff, CA 96080-3016 | 2020-09-17 |
| 1760952683 | Nicole Catherine Van Dyke | Marriage & Family Therapist | 20 Antelope Blvd, Red Bluff, CA 96080-2807 | 2018-12-04 |
| 1588043202 | Jennifer Alldredge | Marriage & Family Therapist | 590 Antelope Blvd Ste 20, Red Bluff, CA 96080-2474 | 2015-05-27 |
| 1891182663 | Dana Thomas | Marriage & Family Therapist | 19850 Siesta Way, Red Bluff, CA 96080-9626 | 2015-04-20 |
| 1457778052 | Cheryl Stewart | Marriage & Family Therapist | 590 Antelope Blvd Ste 30, Red Bluff, CA 96080-2474 | 2014-03-21 |
| 1790026375 | Frances Elena Romero | Marriage & Family Therapist | Po Box 950, Red Bluff, CA 96080-0950 | 2013-03-07 |
| 1679825723 | Mandy Erin Woodman | Marriage & Family Therapist | 900 Palm St, Red Bluff, CA 96080-2626 | 2012-10-12 |
| 1598059800 | Megan Marie Meehan | Marriage & Family Therapist | 717 Pine St, Red Bluff, CA 96080-3743 | 2011-06-03 |
| 1376726372 | David B Morris | Marriage & Family Therapist | 246 Treasure Dr, Red Bluff, CA 96080-2123 | 2007-12-12 |
| 1639366446 | Kathryn Elaine Ross | Marriage & Family Therapist | 105 Sale Ln, Red Bluff, CA 96080-2932 | 2007-09-26 |
| Find all providers in RED BLUFF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.