Provider Demographics
NPI:1295866473
Name:GONZALEZ, GISELLE CHRISTINA (BS)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:CHRISTINA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 MARINA VILLAGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6427
Mailing Address - Country:US
Mailing Address - Phone:510-747-0527
Mailing Address - Fax:510-337-7969
Practice Address - Street 1:1475 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5990
Practice Address - Country:US
Practice Address - Phone:650-246-3829
Practice Address - Fax:650-246-3838
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist