Provider Demographics
NPI:1104217652
Name:GONZALES DE GARCIA, BABETTE JOYCE (LPT)
Entity Type:Individual
Prefix:
First Name:BABETTE
Middle Name:JOYCE
Last Name:GONZALES DE GARCIA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:BABETTE
Other - Middle Name:JOYCE
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-2345
Mailing Address - Country:US
Mailing Address - Phone:909-272-7906
Mailing Address - Fax:
Practice Address - Street 1:820 MONTEREY AVE
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2345
Practice Address - Country:US
Practice Address - Phone:909-272-7906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29291167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician