Healthcare Provider Details

I. General information

NPI: 1710800537
Provider Name (Legal Business Name): ALENA CRISTINA GONZALEZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W GLENDALE AVE STE 203
PHOENIX AZ
85021-7673
US

IV. Provider business mailing address

7700 W ASPERA BLVD APT 3056
GLENDALE AZ
85308-7931
US

V. Phone/Fax

Practice location:
  • Phone: 602-772-5770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11964
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: