Provider Demographics
NPI:1912269481
Name:GONZALES, EVA CRUZ (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:CRUZ
Last Name:GONZALES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16585 DE WITT AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4711
Mailing Address - Country:US
Mailing Address - Phone:408-568-0727
Mailing Address - Fax:408-782-0494
Practice Address - Street 1:16585 DE WITT AVE
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4711
Practice Address - Country:US
Practice Address - Phone:408-568-0727
Practice Address - Fax:408-782-0494
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA439544163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management