Provider Demographics
NPI:1467191080
Name:GONZALEZ, ANA PATRICIA (MPH RRT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:PATRICIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MPH RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BRIGANTINE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7061
Mailing Address - Country:US
Mailing Address - Phone:702-412-2866
Mailing Address - Fax:
Practice Address - Street 1:5155 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0173
Practice Address - Country:US
Practice Address - Phone:702-869-4401
Practice Address - Fax:702-869-9904
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC22282278P1005X, 2279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation
No2278P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Rehabilitation