Most Relevant Information
Provider Data
| NPI Number: | 1003522897 |
| Provider Name: | THERESA AMMONS GONZALEZ NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 95023849 |
Most Important Dates
| Enumeration Date: | 01/25/2023 |
| Last Updated: | 01/25/2023 |
Provider Practice Location
4700 W SUNSET BLVD FL 3
LOS ANGELES
CA
900276082
Practice Location Phone/Fax
| Phone: | 3237836970 |
| Fax: | 3237830113 |
Provider Mailing Location
430 JENNY DR
NEWBURY PARK
CA
913202922
Provider Mailing Phone/Fax
| Phone: | 7325003222 |
| Fax: |