Healthcare Provider Details

I. General information

NPI: 1174456446
Provider Name (Legal Business Name): KARINA FALCON GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 LOIS DR
SUN PRAIRIE WI
53590-1100
US

IV. Provider business mailing address

365 FIR LN
MARSHALL WI
53559-9229
US

V. Phone/Fax

Practice location:
  • Phone: 608-837-9112
  • Fax:
Mailing address:
  • Phone: 608-520-7195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: