Jasmine Mireya Gongora, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT305678 Issued in CA

Practice address

81557 Dr Carreon Blvd Ste C4
Indio, CA 92201-5562

Phone

(760) 347-6195

Fax

(760) 347-2849

NPI assigned

Aug 28, 2023

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 names 1

• Jasmine Richardson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Multicare Health System

  • Cardiovascular Disease Physician
  • Everett, WA
  • NPI 1164185765
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  NPD
• CV Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Indio, CA
  • NPI 1013167527
  NPD (past)

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1093590093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81557 DR CARREON BLVD STE C4",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015562",
            "telephone_number": "760-347-6195",
            "fax_number": "760-347-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGORA",
        "first_name": "JASMINE",
        "middle_name": "MIREYA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT305678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "RICHARDSON",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adriana Gomez
• Araceli Gomez
• Lucy Gonzales Gomez, LVN
• Martha Elizabeth Gomez, LVN
• Susan Gomez
• Christina Lynn Gonzales
• Cindy Pena Gonzales
• Golden Gonzales
• James J Gonzales
• Kathryn Antoinette Gonzales

• Physical Therapist in Indio, CA
• Providers in Indio, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.