Individual
KIMBERLY MICHELLE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9415 CLOVIS AVE, LOS ANGELES, CA 90002-1927
(323) 351-8575
Mailing address
9415 CLOVIS AVE, LOS ANGELES, CA 90002-1927
(323) 351-8575
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94172262D31221
—
CA
Enumeration date
03/22/2022
Last updated
03/22/2022
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