Healthcare Provider Details

I. General information

NPI: 1699326835
Provider Name (Legal Business Name): SONYA RENITA GONZALEZ AU. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 CAMINO VERDE DR STE I
SAN JOSE CA
95119-1401
US

IV. Provider business mailing address

6140 CAMINO VERDE DR STE I
SAN JOSE CA
95119-1401
US

V. Phone/Fax

Practice location:
  • Phone: 408-225-0688
  • Fax:
Mailing address:
  • Phone: 408-225-0688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU4188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: