Provider Demographics
NPI:1518292473
Name:CARREIRO, LIZA GONZALES (RN, RN-BC)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:GONZALES
Last Name:CARREIRO
Suffix:
Gender:F
Credentials:RN, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3658 N BURGAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-7976
Mailing Address - Country:US
Mailing Address - Phone:559-292-7009
Mailing Address - Fax:
Practice Address - Street 1:3658 N BURGAN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-7976
Practice Address - Country:US
Practice Address - Phone:559-292-7009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567226163WM0705X, 163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WX0200XNursing Service ProvidersRegistered NurseOncology