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General NPI Number Information
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NPI Number | 1720455470
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Entity Type | Individual
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Provider Name | BIANCA GONZALEZ NP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 576 E EL CAMINO REAL
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City | SUNNYVALE
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State | CA
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Zip | 94087-1940
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Country | US
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Telephone | 310-890-4497
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CALIFORNIA AVE UNIT 107
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City | SANTA MONICA
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State | CA
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Zip | 90403-3516
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Country | US
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Telephone | 310-890-4497
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95002580
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License Number State | CA
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