Provider Demographics
NPI:1972003325
Name:GONELLA, JOANIE S (CPE)
Entity type:Individual
Prefix:
First Name:JOANIE
Middle Name:S
Last Name:GONELLA
Suffix:
Gender:F
Credentials:CPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 E MCFADDEN AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4648
Mailing Address - Country:US
Mailing Address - Phone:714-922-0337
Mailing Address - Fax:
Practice Address - Street 1:1780 E MCFADDEN AVE STE 115
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4648
Practice Address - Country:US
Practice Address - Phone:714-922-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL8410174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist