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Individual

BREANNA MARIE GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS

Contact information

Practice address
515 E 6TH ST, ONTARIO, CA 91764-1818
(909) 984-5618
Mailing address
950 W D ST, ONTARIO, CA 91762-3026

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0022053150
CA
Enumeration date
02/19/2021
Last updated
03/05/2025
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Product
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