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General NPI Number Information
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NPI Number | 1821972670
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Entity Type | Individual
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Provider Name | ELIZABETH UBALDA DEL CARMEN GONZALEZ CMA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1745 HOLLISTER ST UNIT 22
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City | SAN DIEGO
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State | CA
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Zip | 92154-4531
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Country | US
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Telephone | 619-666-4451
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Fax |
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Provider Business Mailing Address
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Address Line | 28475 MOUNTAIN ST
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-1714
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Country | US
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Telephone | 619-359-7386
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | CA
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