Provider Demographics
NPI:1952711624
Name:GONZALEZ-MILLER, MONICA (LAC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:GONZALEZ-MILLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5065 RHOADS AVE, #C
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111
Mailing Address - Country:US
Mailing Address - Phone:805-729-4403
Mailing Address - Fax:
Practice Address - Street 1:22 N. MILPAS STREET
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103
Practice Address - Country:US
Practice Address - Phone:805-729-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15928171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist