Provider Demographics
NPI:1760440150
Name:GONZALEZ, MARIA NINA A (MD)
Entity Type:Individual
Prefix:
First Name:MARIA NINA
Middle Name:A
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10810 SAN PABLO AVE
Mailing Address - Street 2:APT # A313
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-2399
Mailing Address - Country:US
Mailing Address - Phone:508-826-0463
Mailing Address - Fax:
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:KAISER VALLEJO, DEPARTMENT OF NEUROLOGY
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-651-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2241302084N0400X
CAA954782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology