Provider Demographics
NPI:1205472875
Name:GONZALEZ, SARAH NICOLE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 S FRUIT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-9604
Mailing Address - Country:US
Mailing Address - Phone:559-960-3878
Mailing Address - Fax:
Practice Address - Street 1:1470 W HERNDON AVE STE 300
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-0552
Practice Address - Country:US
Practice Address - Phone:559-256-2000
Practice Address - Fax:559-256-3000
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker