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General NPI Number Information
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NPI Number | 1417836537
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Entity Type | Individual
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Provider Name | JOANNA GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2505 W SHAW AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93711-3334
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Country | US
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Telephone | 559-307-3828
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Fax |
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Provider Business Mailing Address
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Address Line | 6361 E DWIGHT WAY
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City | FRESNO
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State | CA
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Zip | 93727-5856
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Country | US
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Telephone | 559-974-9528
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 7251
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License Number State | CA
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