Provider Demographics
NPI:1386849776
Name:GONZALEZ, PATRICIA CHRISTINE (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CHRISTINE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:714-347-1000
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:5801 NORRIS CANYON RD
Practice Address - Street 2:STE 230
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5440
Practice Address - Country:US
Practice Address - Phone:925-275-9910
Practice Address - Fax:925-275-9823
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3254742367500000X
CA95000360367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308542200Medicaid
CACA194843 (EMP-CC)Medicare PIN
CACA194842 (EMP-AL)Medicare PIN
FL308542200Medicaid
FLAF805WMedicare PIN