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General NPI Number Information
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NPI Number | 1831505486
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Entity Type | Individual
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Provider Name | LIZBETH GONZALEZ SWC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 1301 RIVERSIDE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80524-4374
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Country | US
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Telephone | 970-888-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 5720 W COUNTY ROAD 54 E
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City | BELLVUE
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State | CO
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Zip | 80512-7122
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Country | US
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Telephone | 970-308-0473
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA00737225
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWC.0000000707
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License Number State | CO
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