Provider Demographics
NPI:1932896719
Name:GONZALEZ, STEVIE
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:
Last Name: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 1:9254 LA DOCENA LN
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-5228
Mailing Address - Country:US
Mailing Address - Phone:562-322-1568
Mailing Address - Fax:
Practice Address - Street 1:9254 LA DOCENA LN
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-5228
Practice Address - Country:US
Practice Address - Phone:562-322-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula