Individual
ANGELA LYNN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 E WALNUT AVE, LOMPOC, CA 93436-7027
(805) 735-3714
Mailing address
425 S I ST, LOMPOC, CA 93436-7701
(805) 315-5168
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
4715
CA
2255A2300X
Athletic Trainer
Primary
069202417
CA
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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