Individual
SEVILLA GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2349 S AZUSA AVE, WEST COVINA, CA 91792-1533
(626) 780-6941
Mailing address
2349 S AZUSA AVE, WEST COVINA, CA 91792-1533
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
194700938
—
Other
Enumeration date
05/22/2024
Last updated
09/11/2025
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