Healthcare Provider Details

I. General information

NPI: 1235009671
Provider Name (Legal Business Name): KINARI GONZALEZ GUILIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 HEFFERNAN AVE STE D
CALEXICO CA
92231-4718
US

IV. Provider business mailing address

434 MCKINLEY ST
CALEXICO CA
92231-2092
US

V. Phone/Fax

Practice location:
  • Phone: 760-270-9126
  • Fax:
Mailing address:
  • Phone: 442-250-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number755622
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: