Individual provider Active NPI

Guadalupe Gonzalez

  • Marriage & Family Therapist
  • El Centro, CA
National Provider Identifier
1134730344
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
146534 Issued in CA
Practice address
1600 S Imperial Ave Ste 5
El Centro, CA 92243-4242
Phone
(442) 283-5860
Fax
(442) 283-5860
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 146534 CA Primary

Addresses

Primary practice location

1600 S Imperial Ave Ste 5
El Centro, CA 92243-4242

Mailing address

PO Box 1114
El Centro, CA 92244-1114
Phone (760) 604-6241

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
I20240816000386 CA Practitioner - Marriage and Family Therapist 6901344399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alidad Zadeh DO, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Womanhaven, Inc. PastSince Aug 1, 2020 Accepting new patients

Locations

1600 S Imperial Ave
Ste 5
El Centro, CA 92243
Phone (442) 283-5861

1600 S Imperial Ave
Ste 3
El Centro, CA 92243
Phone (760) 335-3545

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1134730344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1114",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922441114",
            "telephone_number": "760-604-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S IMPERIAL AVE STE 5",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434242",
            "telephone_number": "442-283-5860",
            "fax_number": "442-283-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GUADALUPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.