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General NPI Number Information
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NPI Number | 1275801425
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Entity Type | Individual
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Provider Name | LISA ELIZABETH GONZALES CNM
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Gender | Female
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 2020 SUTTER PL STE 203
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City | DAVIS
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State | CA
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Zip | 95616-6217
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Country | US
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Telephone | 530-750-5880
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Fax | 530-750-5881
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone | 800-470-0071
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Fax | 916-854-6769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0024169804
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 0024169804
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NM236574
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License Number State | CA
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