Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033557822 |
---|---|
Provider Name | Ms. Cristina Isela Gonzalez |
First Address | Pico Rivera, CA 90660-2405 |
Second Address | Pico Rivera, CA 90660-2405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2013 |
Last Update Date | 13/06/2013 |