Provider Demographics
NPI:1841053618
Name:GONZALEZ, MARIA ROSARIO (RCFE ADMINISTRATOR)
Entity type:Individual
Prefix:
First Name:MARIA ROSARIO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RCFE ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43190 SAN MIGUEL WAY
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-5155
Mailing Address - Country:US
Mailing Address - Phone:951-335-1239
Mailing Address - Fax:951-392-2535
Practice Address - Street 1:862 PIKE DR
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-7823
Practice Address - Country:US
Practice Address - Phone:951-335-1239
Practice Address - Fax:951-392-2535
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant