Individual provider Active NPI

Brandy Gonzales, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1003557190
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95033375 Issued in CA
Practice address
6060 N Paramount Blvd
Long Beach, CA 90805-3711
Phone
(562) 634-9534
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95218091 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95033375 CA Primary

Addresses

Primary practice location

6060 N Paramount Blvd
Long Beach, CA 90805-3711

Mailing address

16314 Cornuta Ave
Bellflower, CA 90706-4814
Phone (562) 461-9272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509002256 CA Practitioner - Nurse Practitioner 0244757458 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95218091CAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince May 1, 2025 Accepting new patients
Southern California Alcohol & Drug Programs, Inc. PastSince Apr 20, 2025 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

1255 Treat Blvd
Ste 300
Walnut Creek, CA 94597
Phone (707) 953-9977

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1003557190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16314 CORNUTA AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907064814",
            "telephone_number": "562-461-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 N PARAMOUNT BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908053711",
            "telephone_number": "562-634-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "BRANDY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95218091",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95033375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.