Healthcare Provider Details

I. General information

NPI: 1437693926
Provider Name (Legal Business Name): JENNIFER ASHLEY GONZALEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ASHELY LORENZANA ARNP

II. Dates (important events)

Enumeration Date: 12/19/2016
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 E 6TH ST
LOS ANGELES CA
90014-2117
US

IV. Provider business mailing address

242 E 6TH ST
LOS ANGELES CA
90014-2117
US

V. Phone/Fax

Practice location:
  • Phone: 213-833-5300
  • Fax:
Mailing address:
  • Phone: 130-572-0126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9338052
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: