Provider Demographics
NPI:1063171833
Name:NUNEZ GONZALEZ, ARLENE MARIA
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARIA
Last Name:NUNEZ GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W BELGRAVIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-3909
Mailing Address - Country:US
Mailing Address - Phone:559-265-2045
Mailing Address - Fax:
Practice Address - Street 1:900 W BELGRAVIA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3909
Practice Address - Country:US
Practice Address - Phone:559-265-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COE162530146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAY8762239OtherDRIVERS LICENSE