Individual
VIVIAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3629 LYNOAK ST STE B, POMONA, CA 91767-1232
(909) 833-1099
(888) 856-3880
Mailing address
310 N INDIAN HILL BLVD # 413, CLAREMONT, CA 91711-4611
(909) 833-1099
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5199
CA
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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