Healthcare Provider Details

I. General information

NPI: 1013792647
Provider Name (Legal Business Name): ANA LUISA GONZALEZ SANDOVAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 CHESTER AVE STE 101
BAKERSFIELD CA
93301-2016
US

IV. Provider business mailing address

2701 CHESTER AVE STE 101
BAKERSFIELD CA
93301-2016
US

V. Phone/Fax

Practice location:
  • Phone: 661-241-6700
  • Fax:
Mailing address:
  • Phone: 661-241-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95035422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: