Provider Information for 1689233686
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KRISTINA RENE GONZALEZ
Sex: Female
NPI: 1689233686
Last Updated: 2019-06-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1689233686 | ||||||||
| Enumeration Date | 2019-06-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 434 7TH ST STE 210 EUREKA, CA 95501-1803 United States Phone: 707-267-0740 | Fax: | ||||||||
| Primary Practice Address | 434 7TH ST STE 210 EUREKA, CA 95501-1803 United States Phone: 707-267-0740 | Fax: | ||||||||
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