Individual provider Active NPI

Raquel Estrada Gonzalez, PHD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1114080140
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
32207 Issued in TX
Practice address
7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801
Phone
(210) 615-8880
Fax
(210) 615-2279
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 56995 TX
Clinical Psychologist 103TC0700X 32207 TX Primary

Addresses

Primary practice location

7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801

Mailing address

7272 Wurzbach Rd
Suite 601
San Antonio, TX 78240-4801
Phone (210) 615-8880

Other identifiers 1

IdentifierTypeStateIssuer
32207OtherTXLICENSE

Other names 1

  • Raquel Estrada Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190815000400 TX Practitioner - Clinical Psychologist 2860729720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
83.48
Improvement activities
40
Cost
67.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
56995TXMDProfessional Counselor
32207TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C Clinical CurrentSince Jun 20, 2019 Accepting new patients
Deer Oaks Mental Health Associates PC Clinical Past Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1114080140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-8880",
            "fax_number": "210-615-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-8880",
            "fax_number": "210-615-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RAQUEL",
        "middle_name": "ESTRADA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "56995",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "32207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "32207",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAQUEL",
            "last_name": "ESTRADA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.