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General NPI Number Information
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NPI Number | 1912931528
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Entity Type | Individual
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Provider Name | DORAL RENEE GONZALES FNP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 03/30/2008
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Provider Practice Location Address
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Address Line | 930 SUNSET DR BUILDING # 3
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City | HOLLISTER
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State | CA
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Zip | 95023-5780
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Country | US
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Telephone | 831-636-2664
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Fax | 831-636-2641
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Provider Business Mailing Address
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Address Line | 1709 VIA MILANO
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City | GUSTINE
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State | CA
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Zip | 95322-9682
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Country | US
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Telephone | 408-348-1894
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Fax | 209-854-6805
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN 348323
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP 13815
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP1700X
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Taxonomy Name | Perinatal Nurse Practitioner
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License Number | NM 1248
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License Number State | CA
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