Individual provider · NPI-1

Marylin Ruth Cruz Gould, NP

Nurse Practitioner, Obstetrics & Gynecology · Fontana, CA

NPI number1790133205
StatusActive
Last updated in NPPESMay 25, 2016

Details

NPI
1790133205
Entity type
Individual (NPI-1)
Name
Marylin Ruth Cruz Gould
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
May 25, 2016
Last updated
May 25, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LX0001X Nurse Practitioner, Obstetrics & Gynecology95004050CAYes

Practice location

7965 Sierra Ave Ste E
Fontana, CA 92336-3329

Phone 909-356-4459

Mailing address

7965 Sierra Ave Ste E
Fontana, CA 92336-3329

Phone 909-356-4459

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