Provider Demographics
NPI:1457163636
Name:GONZALES, DALINA SOPHIA
Entity type:Individual
Prefix:
First Name:DALINA
Middle Name:SOPHIA
Last Name:GONZALES
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:PO BOX 40073
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94140-0073
Mailing Address - Country:US
Mailing Address - Phone:415-685-7782
Mailing Address - Fax:
Practice Address - Street 1:115 10TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2604
Practice Address - Country:US
Practice Address - Phone:415-360-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker