Gonzalez, Victor

Gonzalez, Victor is an sole proprietor health care provider with primary practice located at 3380 Trickum Rd Building 1000, Suite 102, Woodstock GA 30188-3680. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Gonzalez, Victor can be contacted via phone (770) 924-9700.

Contact Information

Primary practice address
3380 Trickum Rd Building 1000, Suite 102 Woodstock GA 30188-3680
Phone: (770) 924-9700
Fax: (770) 926-0690
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY002448 Georgia
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY002448 Georgia

Profile Details

NPI number 1689861387
LBN Legal business name Gonzalez, Victor
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2007
Last updated Nov 4th, 2011 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689861387 NPPES
Georgia MEDICAID 000913646A

Popular Providers