Angelica Chan Gonzales, ND, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201907006RN Issued in OR

Practice address

20370 Poe Sholes Dr
Bend, OR 97703-7938

Phone

(541) 728-3319

NPI assigned

Oct 28, 2014

Reactivated

Dec 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Angelica Gonzalez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1114322591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63235 BRITTA ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20370 POE SHOLES DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037938",
            "telephone_number": "541-728-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ANGELICA",
        "middle_name": "CHAN",
        "credential": "ND, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "deactivation_date": "2018-01-04",
        "reactivation_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "2078",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201907006RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "GONZALEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ellen Golodner, M.D.
• Julia Ruth Gomes, OTR/L
• Joanne Gomez-Arnold, MD
• Mark Edward Gonsky, DO
• Caroline Gonyea, DPT, PT
• Rodrigo Gonzalez-Juarez, MSW
• Christine Goodall, PA-C
• Rosalie Goode, DT, RDH
• Douglas Goodgion
• Lori Jana Goodman, MD

• Registered Nurse in Bend, OR
• Providers in Bend, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.