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General NPI Number Information
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NPI Number | 1316443799
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Entity Type | Individual
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Provider Name | NANCY ELIZABETH GONZALEZ NP
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 3834 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90062-1104
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Country | US
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Telephone | 323-373-2045
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Fax |
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Provider Business Mailing Address
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Address Line | 21450 BURBANK BLVD APT 309
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-7046
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Country | US
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Telephone | 310-702-3580
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | NP95007469
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License Number State | CA
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