Healthcare Provider Details

I. General information

NPI: 1821935859
Provider Name (Legal Business Name): BILLY GONZALEZ AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 E 2ND ST
NATIONAL CITY CA
91950-1210
US

IV. Provider business mailing address

28 E 2ND ST
NATIONAL CITY CA
91950-1210
US

V. Phone/Fax

Practice location:
  • Phone: 209-996-7733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2026015449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: