Healthcare Provider Details

I. General information

NPI: 1154236081
Provider Name (Legal Business Name): KARLA DANIELA GONZALEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5214 E LOS ALTOS PLZ
LONG BEACH CA
90815-4251
US

IV. Provider business mailing address

2275 EUCALYPTUS AVE APT 3
LONG BEACH CA
90806-4253
US

V. Phone/Fax

Practice location:
  • Phone: 562-597-3035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT310546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: