Individual
JAZMINA MBA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
5914 WESCOTT HILLS WAY, ALEXANDRIA, VA 22315-4740
(571) 271-4767
Mailing address
5914 WESCOTT HILLS WAY, ALEXANDRIA, VA 22315-4740
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
0136000463
VA
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
07/06/2021
Last updated
05/17/2022
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