Provider Demographics
NPI:1346579794
Name:GONZALEZ, BECKY LOU (BIRTH & LABOR DOULA)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:LOU
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BIRTH & LABOR DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4047 IVEY VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7663
Mailing Address - Country:US
Mailing Address - Phone:760-458-5100
Mailing Address - Fax:760-757-5570
Practice Address - Street 1:4047 IVEY VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-7663
Practice Address - Country:US
Practice Address - Phone:760-458-5100
Practice Address - Fax:760-757-5570
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula