Individual
ALYSSA GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2411 CABEZON BLVD SE STE 103, RIO RANCHO, NM 87124-1514
(505) 883-9570
(505) 883-4163
Mailing address
8308 CONSTITUTION PL NE, ALBUQUERQUE, NM 87110-7637
(505) 883-9570
(505) 883-4163
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2005-0043
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00739847
—
NM
Enumeration date
09/07/2007
Last updated
09/25/2025
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