Healthcare Provider Details

I. General information

NPI: 1679484380
Provider Name (Legal Business Name): JOCELYN JOCELYN GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 S TELSHOR BLVD
LAS CRUCES NM
88011-5029
US

IV. Provider business mailing address

2435 S TELSHOR BLVD
LAS CRUCES NM
88011-5029
US

V. Phone/Fax

Practice location:
  • Phone: 575-323-1315
  • Fax: 833-524-5203
Mailing address:
  • Phone: 575-323-1315
  • Fax: 833-524-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: