Individual provider Active NPI

Monica Gonzalez

  • Physician Assistant
  • Soquel, CA
National Provider Identifier
1053794776
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52602 Issued in CA
Practice address
3035 N Main St
Soquel, CA 95073-2204
Phone
(831) 465-8680
Fax
(831) 465-8681
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52602 CA Primary

Addresses

Primary practice location

3035 N Main St
Soquel, CA 95073-2204

Mailing address

3035 N Main St
Soquel, CA 95073-2204
Phone (831) 465-8680

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
I20150922003157 CA Practitioner - Physician Assistant 8820305915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District CurrentSince Jun 26, 2024 Accepting new patients
Kaweah Delta Health Care District CurrentSince Jun 26, 2024 Accepting new patients
Spine Clinic of Monterey Bay Past Accepting new patients

Locations

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

1633 S Court St
Visalia, CA 93277
Phone (559) 624-6090

Organizations & group practices 4

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1053794776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 N MAIN ST",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732204",
            "telephone_number": "831-465-8680",
            "fax_number": "831-465-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 N MAIN ST",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732204",
            "telephone_number": "831-465-8680",
            "fax_number": "831-465-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soquel, CA

Sources for this page

Verify at the official NPI Registry.