Individual
DENISE M GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA-AIDE CMT
Contact information
Practice address
10149 ALTA BRISA WAY, MORENO VALLEY, CA 92557-9019
(818) 602-9163
Mailing address
10149 ALTA BRISA WAY, MORENO VALLEY, CA 92557-9019
(818) 602-9163
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
37810
CA
Other
Enumeration date
09/23/2014
Last updated
04/25/2021
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