Monica Teresa Peterson Gordon, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A86089 Issued in CA

Practice address

1370 S State St Ste B
San Jacinto, CA 92583-4922

Phone

(951) 791-3596

Fax

(951) 791-3397

NPI assigned

Jul 31, 2007

Last updated

Apr 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Saint Louis University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgordon142909@direct.llu.edu

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.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment Care Compare group NPD
• County of Riverside

  dba Moreno Valley Children's Interagency Program

  • Community/Behavioral Health Agency
  • Moreno Valley, CA
  • NPI 1194890541
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1114117603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 S STATE ST STE B",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834922",
            "telephone_number": "951-791-3596",
            "fax_number": "951-791-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 S STATE ST STE B",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834922",
            "telephone_number": "951-791-3596",
            "fax_number": "951-791-3397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E San Jacinto Ave Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925712833",
            "country_code": "US",
            "telephone_number": "951-443-2200",
            "fax_number": "951-443-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MONICA TERESA",
        "middle_name": "PETERSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2021-04-20",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A86089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Gonzalez Vazquez
• Dianne Gonzalez
• Lorraine Anita Gonzalez
• Marina Gonzalez
• Mario Alberto Gonzalez, MSN/FNP
• Ashleigh Gorgeous
• Virginia Nava Gradilla, CNA
• Grandeur Care Hospice LLC
• Khea Gray, LVN
• Susan Louise Gray, LVN

• Psychiatry Physician in San Jacinto, CA
• Providers in San Jacinto, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.