Healthcare Provider Details

I. General information

NPI: 1366569832
Provider Name (Legal Business Name): MS. IRMA P. GONZALEZ II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 NATIVIDAD RD ROOM 200
SALINAS CA
93906-3122
US

IV. Provider business mailing address

1270 NATIVIDAD RD ROOM 200
SALINAS CA
93906-3122
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-6402
  • Fax: 831-751-6771
Mailing address:
  • Phone: 831-796-6402
  • Fax: 831-751-6771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: