Active NPI
Henry A. Gonzalez, RAS
- Addiction (Substance Use Disorder) Counselor
- Riverside, CA
National Provider Identifier
1043400591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1021 W la Cadena Dr
Riverside, CA 92501-1413 - Phone
- (951) 784-8010
- Fax
- (951) 784-2859
- NPI assigned
- Jul 31, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | GO412291733 | CA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
1021 W la Cadena Dr
Riverside, CA 92501-1413
Mailing address
735 N D St
San Bernardino, CA 92401-1111
Phone (909) 381-5507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GO412291733 | Other | CA | SUBSTANCE ABUSE COUNSELOR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GO412291733 | CA | MD | Case Manager/Care Coordinator |
Practice roles
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.
-
- Methadone Clinic
- Riverside, CA
- NPI 1194735829
-
- Methadone Clinic
- Bellingham, WA
- NPI 1811592116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1043400591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "735 N D ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924011111",
"telephone_number": "909-381-5507",
"fax_number": "909-888-5938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 W LA CADENA DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925011413",
"telephone_number": "951-784-8010",
"fax_number": "951-784-2859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "HENRY",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "RAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-31",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "GO412291733",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUBSTANCE ABUSE COUNSELOR",
"identifier": "GO412291733",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.