Individual provider Active NPI

Olga Lydia Gonzalez, MD

  • Pediatrics Physician
  • Yuba City, CA
National Provider Identifier
1063510063
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G077811 Issued in CA
Practice address
1231 Plumas St
Yuba City, CA 95991-3410
Phone
(530) 751-8454
Fax
(530) 751-8456
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G077811 CA Primary

Addresses

Primary practice location

1231 Plumas St
Yuba City, CA 95991-3410

Mailing address

2145 5TH Ave
Oroville, CA 95965-5870
Phone (530) 751-8454

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140806001564 CA Practitioner - Pediatric Medicine 2961629449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G077811CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Feather River Tribal Health Inc CurrentSince Apr 8, 2019 Accepting new patients
Feather River Tribal Health Inc Past Accepting new patients
Rideout Memorial Hospital Past Accepting new patients

Locations

2145 5th Ave
Oroville, CA 95965
Phone (530) 534-3793

555 W Onstott Rd
Yuba City, CA 95993
Phone (530) 751-8454

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1063510063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 5TH AVE",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959655870",
            "telephone_number": "530-751-8454",
            "fax_number": "530-751-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 PLUMAS ST",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913410",
            "telephone_number": "530-751-8454",
            "fax_number": "530-751-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "OLGA",
        "middle_name": "LYDIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G077811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.