Individual
JODY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 W FERN AVE, REDLANDS, CA 92373-4918
(909) 793-2609
Mailing address
1620 W FERN AVE, REDLANDS, CA 92373-4918
(909) 793-2609
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA374
CA
Other
Enumeration date
05/05/2017
Last updated
05/05/2017
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