Active NPI
Betty Lou Gonzales
- Health Educator
- Farmington, NM
National Provider Identifier
1013451897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 1001 W Broadway Ste D
Farmington, NM 87401-5638 - Phone
- (505) 327-4796
- NPI assigned
- Dec 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
1001 W Broadway Ste D
Farmington, NM 87401-5638
Mailing address
2300 Ridgecrest Dr
Farmington, NM 87401-3408
Phone (505) 402-6626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502236800000",
"number": "1013451897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 RIDGECREST DR",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874013408",
"telephone_number": "505-402-6626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 W BROADWAY STE D",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015638",
"telephone_number": "505-327-4796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "BETTY",
"middle_name": "LOU",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-13",
"last_updated": "2017-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.