Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DDS62322 | CA |
NPI | 1205284312 |
---|---|
Provider Name | Veronica G Gonzalez |
First Address | Menlo Park, CA 94025-3663 |
Second Address | Menlo Park, CA 94025-3663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2016 |
Last Update Date | 12/07/2021 |