Provider Demographics
NPI:1578656310
Name:GONZALES-HAMILTON, BERNADETTE (DC)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:GONZALES-HAMILTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27710 JEFFERSON AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2669
Mailing Address - Country:US
Mailing Address - Phone:951-208-7711
Mailing Address - Fax:951-905-1387
Practice Address - Street 1:27710 JEFFERSON AVE STE 106
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2669
Practice Address - Country:US
Practice Address - Phone:951-208-7711
Practice Address - Fax:951-905-1387
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor