Provider Demographics
NPI:1508338005
Name:GONZALEZ, DIGNA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:DIGNA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10152 LEMONA AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-2704
Mailing Address - Country:US
Mailing Address - Phone:818-900-8781
Mailing Address - Fax:
Practice Address - Street 1:10716 LA TUNA CANYON RD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2130
Practice Address - Country:US
Practice Address - Phone:818-252-5863
Practice Address - Fax:818-252-6450
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295749225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist