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NPI Code Detail

MEDICARE: MISS MARIA ELIZABETH GONZALEZ-JACQUEZ LVN

MEDICARE: MISS MARIA ELIZABETH GONZALEZ-JACQUEZ LVN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse201808CA

General Provider Information

NPI Number : 1578735718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARIA ELIZABETH GONZALEZ-JACQUEZ LVN
Provider Business Mailing Address
First Line : 3433 W SHAW AVE STE 108
Second Line :
City : FRESNO
State : CA
Zip : 93711-3229
Country : US
Telephone Number : 559-558-4051
Fax Number :
Provider Business Practice Location Address
First Line : 496 S BARTON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93702-2985
Country : US
Telephone Number : 559-860-4422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 01/12/2024

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