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General NPI Number Information
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NPI Number | 1780467001
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Entity Type | Individual
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Provider Name | JOANNA M GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 1225 M ST
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City | FRESNO
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State | CA
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Zip | 93721-1805
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Country | US
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Telephone | 559-600-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 2406 GARVEY AVE
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City | CORCORAN
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State | CA
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Zip | 93212-1515
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Country | US
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Telephone | 623-202-3425
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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 | 95023499
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License Number State | CA
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