Provider Demographics
NPI:1194777003
Name:GONZALEZ, ARASELIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:ARASELIA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 HILLMAN ST.
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274
Mailing Address - Country:US
Mailing Address - Phone:559-605-0090
Mailing Address - Fax:559-605-0092
Practice Address - Street 1:2059 HILLMAN ST.
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274
Practice Address - Country:US
Practice Address - Phone:559-605-0090
Practice Address - Fax:559-605-0092
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA359314363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP72087Medicare UPIN