Provider Demographics
NPI:1467943506
Name:GONZALES, CECILIA CHRISTINE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:CHRISTINE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7557 IRONWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3130
Mailing Address - Country:US
Mailing Address - Phone:956-357-0441
Mailing Address - Fax:
Practice Address - Street 1:613 VICTORIA LN
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-0235
Practice Address - Country:US
Practice Address - Phone:956-365-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136953363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health