Provider Demographics
NPI:1932411253
Name:GONZALES, MARI FRANCIS DELA ROSA (LVN)
Entity Type:Individual
Prefix:MRS
First Name:MARI FRANCIS
Middle Name:DELA ROSA
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 CARROLL ST.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124
Mailing Address - Country:US
Mailing Address - Phone:415-822-8200
Mailing Address - Fax:415-822-8203
Practice Address - Street 1:1625 CARROLL ST.
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124
Practice Address - Country:US
Practice Address - Phone:415-822-8200
Practice Address - Fax:415-822-8203
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA223405164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse