Individual provider Active NPI

Maricela Gonzalez

  • Ambulatory Care Registered Nurse
  • Los Angeles, CA
National Provider Identifier
1093243933
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
657376 Issued in CA
Practice address
5850 S Main St
Los Angeles, CA 90003-1215
Phone
(323) 897-6000
Fax
(323) 846-4410
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 657376 CA Primary

Addresses

Primary practice location

5850 S Main St
Los Angeles, CA 90003-1215

Mailing address

4104 W 165TH St
Lawndale, CA 90260-3023
Phone (310) 894-1892

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

LicenseStateTypeSpecialty
657376CAMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1093243933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 W 165TH ST",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603023",
            "telephone_number": "310-894-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 S MAIN ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031215",
            "telephone_number": "323-897-6000",
            "fax_number": "323-846-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARICELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "657376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.