Gonzales, Ricardo R

Gonzales, Ricardo R is an individual health care provider with primary practice located at 168 Ave. De San Marcos , Glorieta NM 87535. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Gonzales, Ricardo R can be contacted via phone (505) 757-2216.

Contact Information

Primary practice address
168 Ave. De San Marcos Glorieta NM 87535
Phone: (505) 757-2216
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3779 New Mexico
Behavioral Health & Social Service Providers / Clinical 103TC0700X 414 New Mexico

Profile Details

NPI number 1932185840
LBN Legal business name Gonzales, Ricardo R
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jan 14th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932185840 NPPES
New Mexico MEDICAID N1903
New Mexico MEDICAID N6708/N1903
New Mexico MEDICAID N6708

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