Individual provider Active NPI

Gloria Aimee Gonzalez, CNM

  • Advanced Practice Midwife
  • Davis, CA
National Provider Identifier
1093314601
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236136 Issued in CA
Practice address
2051 John Jones Rd
Davis, CA 95616-9701
Phone
(530) 758-2060
Fax
(530) 758-8490
NPI assigned
Oct 23, 2020
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 236136 CA Primary

Addresses

Primary practice location

2051 John Jones Rd
Davis, CA 95616-9701

Mailing address

1820 E Gum Ave
Woodland, CA 95776-9390
Phone (530) 219-6614

Other practice location 1

215 W Beamer St
Woodland, CA 95695-2510
Phone (530) 405-2900

Other practice location 2

500 Jefferson Blvd Ste B180
West Sacramento, CA 95605-2394
Phone (916) 403-2900

Other names 1

  • Gloria Aimee Leyva Gonzalez Other name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201204001505 CA Practitioner - Certified Nurse Midwife (CNM) 2163833617 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Ole Health CurrentSince Dec 23, 2020 Accepting new patients
Ole Health CurrentSince Dec 23, 2020 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Ole Health Past Accepting new patients

Locations

2051 John Jones Rd
Davis, CA 95616
Phone (530) 753-3498

500 Jefferson Blvd
Ste 180
West Sacramento, CA 95605
Phone (916) 403-2900

500 Jefferson Blvd
Ste B180
West Sacramento, CA 95605
Phone (916) 375-6400

215 W Beamer St
Woodland, CA 95695
Phone (530) 405-2800

Interoperability endpoints

  • Direct secure messaging: ggonzalez675678@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1093314601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E GUM AVE",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957769390",
            "telephone_number": "530-219-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 JOHN JONES RD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956169701",
            "telephone_number": "530-758-2060",
            "fax_number": "530-758-8490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 W Beamer St",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "956952510",
            "country_code": "US",
            "telephone_number": "530-405-2900",
            "fax_number": "530-204-5255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Jefferson Blvd Ste B180",
            "address_purpose": "LOCATION",
            "city": "West Sacramento",
            "state": "CA",
            "postal_code": "956052394",
            "country_code": "US",
            "telephone_number": "916-403-2900",
            "fax_number": "530-204-5248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GLORIA",
        "middle_name": "AIMEE",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "LEYVA GONZALEZ",
            "middle_name": "AIMEE",
            "credential": "CNM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.