Provider Demographics
NPI:1780460600
Name:GONZALEZ, VICTORIA XOCHITL
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:XOCHITL
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 1:4500 TRUXEL RD APT 1533
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3748
Mailing Address - Country:US
Mailing Address - Phone:408-499-8973
Mailing Address - Fax:
Practice Address - Street 1:4500 TRUXEL RD APT 1533
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-3748
Practice Address - Country:US
Practice Address - Phone:408-499-8973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708460164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse