Healthcare Provider Details

I. General information

NPI: 1851263362
Provider Name (Legal Business Name): RUT ARACELY GONZALEZ LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11902 ROSECRANS AVE
NORWALK CA
90650-4197
US

IV. Provider business mailing address

9139 RAMONA ST UNIT 11
BELLFLOWER CA
90706-7400
US

V. Phone/Fax

Practice location:
  • Phone: 562-929-7188
  • Fax: 562-929-7575
Mailing address:
  • Phone: 424-364-7914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number752231
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: