Provider Demographics
NPI:1538987144
Name:GONZALEZ DE LOS SANTOS, ELISA (FNP)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:GONZALEZ DE LOS SANTOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELISA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5922 ESMERELDA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-4724
Mailing Address - Country:US
Mailing Address - Phone:661-283-5400
Mailing Address - Fax:
Practice Address - Street 1:4580 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1104
Practice Address - Country:US
Practice Address - Phone:661-327-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031557363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner