Individual ProviderTania GonzalezMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address3850 Crenshaw Blvd, Los Angeles, CA 90008-1821(323) 751-3026PECOS EnrollmentBased on the most recent information from CMS, provider Tania Gonzalez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1609400597Provider TypeIndividualFull NameGonzalez, TaniaGenderFemaleSole ProprietorYesEnumeration Date2/28/2020Last Updated2/6/2024Contact InformationPractice LocationPractice Address3850 Crenshaw Blvd, Los Angeles, CA 90008-1821Phone(323) 751-3026FaxUnlisted FaxMailing LocationMailing Address3850 Crenshaw Blvd, Los Angeles, CA 90008-1821Phone(323) 751-3026FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense144745CaliforniaCode172V00000XDescriptionCommunity Health WorkerOther Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID7368DescriptionOtherIssuerMEDICALCaliforniaID7708DescriptionOtherIssuerMEDICALCaliforniaID7184DescriptionOtherIssuerMEDICALCaliforniaID7667DescriptionOtherIssuerMEDICALCalifornia