Gonzales, Lisa

Gonzales, Lisa is an individual health care provider with primary practice located at 118 S College St , La Habra CA 90631-5503. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Gonzales, Lisa can be contacted via phone (562) 256-7550.

Contact Information

Primary practice address
118 S College St La Habra CA 90631-5503
Phone: (562) 256-7550
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X 576 California

Profile Details

NPI number 1700155348
LBN Legal business name Gonzales, Lisa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2011
Last updated Dec 28th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700155348 NPPES
California MEDICAID 576

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