Individual
MR. JESSE GONZAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
350 HAWTHORNE AVE, OAKLAND, CA 94609-3108
(510) 869-8660
Mailing address
3012 SUMMIT ST FL 2, OAKLAND, CA 94609-3480
(510) 869-8660
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11763
CA
Other
Enumeration date
12/02/2006
Last updated
07/08/2007
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