Individual
JACQUELINE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9864 BALDWIN PLACE, EL MONTE, CA 91731
(626) 433-1311
Mailing address
23301 QUAIL SUMMIT DRIVE, DIAMOND BAR, CA 91765
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95160427
CA
167G00000X
Licensed Psychiatric Technician
Primary
32511
CA
Other
Enumeration date
06/08/2007
Last updated
02/04/2019
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