Provider Demographics
NPI:1336293505
Name:GONZALEZ, EDITH F
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:F
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE COVE
Mailing Address - State:CA
Mailing Address - Zip Code:93646-2128
Mailing Address - Country:US
Mailing Address - Phone:559-626-4933
Mailing Address - Fax:
Practice Address - Street 1:1131 I ST
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-3314
Practice Address - Country:US
Practice Address - Phone:559-638-8588
Practice Address - Fax:559-643-8073
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner