Provider Demographics
NPI:1801580642
Name:GONZALEZ, CHRISTINE MICHELLE (PMHNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 E TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-1721
Mailing Address - Country:US
Mailing Address - Phone:480-231-9873
Mailing Address - Fax:
Practice Address - Street 1:3418 E TERRACE AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-1721
Practice Address - Country:US
Practice Address - Phone:480-231-9873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ292680363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health