Vicki Nicole Gonzalez Jr.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95020546 Issued in CA

Practice address

742 W Highland Ave
San Bernardino, CA 92405-3839

Phone

(909) 881-7320

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: vicki.gonzalez.p1@direct.metro.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1083335111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "VICKI",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95020546",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruben Diego Gonzalez
• Ruth Gonzalez
• Sandra Gonzalez
• Sarai Gonzalez
• Tatiana Gonzalez
• William Hyunhak Goo, MD
• Good Life Home Health
• Carolyn Elizabeth Good, MPH
• Topaz Lonia Good, LMFT/PSYCH ASSOCIATE
• Ariba Goode

• Nurse Practitioner in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.