Individual
SUSANA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
4655 RUFFNER ST STE 270, SAN DIEGO, CA 92111-2276
(800) 787-6787
Mailing address
1451 YOSEMITE DR, LOS ANGELES, CA 90041-2808
(323) 257-8763
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1298
CA
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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