Doctor Name: | VIVIAN YVETTE GONZALEZ |
NPI Number: | 1023316619 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 20013 |
Business Practice Address: | 1500 Duarte Rd Duarte, CA - 910103012 |
Business Phone Number: | 6264719200 |
Business Fax Number: | 6263018233 |
Mailing Address: | 1333s Mayflower Ave 2, MONROVIA |
State: | CA |
Postal Code: | 910164066 |
Phone Number: | 6267753514 |
Fax Number: | 6264083911 |
NPI Enumeration Date: | 03/04/2011 |
NPI Last Update Date: | 09/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 20013 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |