Provider Demographics
NPI:1952421000
Name:GONZALEZ, VERONICA VALDEZ (BA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:VALDEZ
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:14833 HELWIG AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6025
Mailing Address - Country:US
Mailing Address - Phone:805-801-4724
Mailing Address - Fax:
Practice Address - Street 1:12099 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5882
Practice Address - Country:US
Practice Address - Phone:310-751-1174
Practice Address - Fax:310-313-7652
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner