Provider Demographics
NPI:1043332174
Name:GONZALEZ, ANA PILAR
Entity Type:Individual
Prefix:MISS
First Name:ANA
Middle Name:PILAR
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANA
Other - Middle Name:PILAR
Other - Last Name:PETITTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12740 LAUREL ST UNIT 402
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-2117
Mailing Address - Country:US
Mailing Address - Phone:619-334-5376
Mailing Address - Fax:619-749-3991
Practice Address - Street 1:5005 TEXAS ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3723
Practice Address - Country:US
Practice Address - Phone:619-692-0727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator