Provider Demographics
NPI:1902580004
Name:GONZALEZ, VANESSA LINDA
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LINDA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 DAVEDALY CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-5881
Mailing Address - Country:US
Mailing Address - Phone:661-332-2475
Mailing Address - Fax:
Practice Address - Street 1:701 SCOFIELD AVE
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-7515
Practice Address - Country:US
Practice Address - Phone:661-332-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program