| Ariel Gonzales Psychiatric Np, Pllc | |
|
5691 S Redwood Rd Bldg 16, Ste 1b Taylorsville UT 84123-5420 | |
| (801) 746-7190 | |
| (866) 284-3243 |
| Full Name | Ariel Gonzales Psychiatric Np, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5691 S Redwood Rd, Taylorsville, Utah |
| Authorized Official Name and Position | Ariel Gonzales (OWNER) |
| Authorized Official Contact | 8017467190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ariel Gonzales Psychiatric Np, Pllc 5691 S Redwood Rd Bldg 16, Ste 1b Taylorsville UT 84123-5420 Ph: (801) 746-7190 | Ariel Gonzales Psychiatric Np, Pllc 5691 S Redwood Rd Bldg 16, Ste 1b Taylorsville UT 84123-5420 Ph: (801) 746-7190 |
| NPI Number | 1366860777 |
|---|---|
| Provider Enumeration Date | 04/02/2014 |
| Last Update Date | 07/02/2014 |
| Medicare PECOS PAC ID | 4385864230 |
|---|---|
| Medicare Enrollment ID | O20140929000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366860777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 8566732-0162 (Utah) | Primary |
| Provider Name | Ariel H Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639409089 PECOS PAC ID: 8921221565 Enrollment ID: I20140528002313 |
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