Active NPI
Breanna Marie Gonzalez, BS
- Health & Wellness Coach
- Ontario, CA
National Provider Identifier
1073106159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Practice address
- 515 E 6TH St
Ontario, CA 91764-1818 - Phone
- (909) 984-5618
- NPI assigned
- Feb 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | Primary |
Addresses
Primary practice location
515 E 6TH St
Ontario, CA 91764-1818
Mailing address
950 W D St
Ontario, CA 91762-3026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0022053150 | Medicaid | CA |
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
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741132800000",
"number": "1073106159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 W D ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917623026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 E 6TH ST",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917641818",
"telephone_number": "909-984-5618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "BREANNA",
"middle_name": "MARIE",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2025-03-05",
"certification_date": "2025-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0022053150",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.