Healthcare Provider Details

I. General information

NPI: 1073478350
Provider Name (Legal Business Name): TRISHAWNA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 WORKMAN ST
BAKERSFIELD CA
93307-6800
US

IV. Provider business mailing address

6803 NEWQUIST DR
BAKERSFIELD CA
93306-7847
US

V. Phone/Fax

Practice location:
  • Phone: 661-335-7140
  • Fax:
Mailing address:
  • Phone: 661-444-5967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95139942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: