Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN J GONSALVES, RADT
ActiveETHAN J GONSALVES, RADT is a Addiction (Substance Use Disorder) Counselor healthcare provider located in SAN LUIS OBISPO, California. NPI 1053035402 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · SAN LUIS OBISPO, CA
Registration Details
- NPI Number
- 1053035402
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 29, 2022 (3.8671916380958 yrs)
- Last Updated
- Sep 29, 2022
- License
-
R1475210722 (CA)
Practice Information
- Address
-
34 PRADOSAN LUIS OBISPO, CA, 93401Browse CA providers · Browse ZIP 93401
- Phone
- 8055191405
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in SAN LUIS OBISPO, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. MICHELLE LYNN LYNCH | — | 1508993684 |
| MR. ROBERT DREW OTTEN | LAADC, M-RAS, CSC | 1447387345 |
| MR. KIRK ERNEST ESTES | CATC #112944 | 1144357054 |
| MS. MARDI A. GEREDES | MA, RRW | 1194931014 |
| STEVE BERG | CATC | 1922218775 |
| MR. FRANK ANTHONY WARREN | — | 1043414774 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.