Individual provider Active NPI

Jessica M Rosario Gonzalez, AU.D.

  • Audiologist
  • Redlands, CA
National Provider Identifier
1144661612
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2936 Issued in CA
Practice address
16 E Fern Ave
Ste C
Redlands, CA 92373-4000
Phone
(909) 792-0074
Fax
(909) 792-8670
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80529 TX
Audiologist-Hearing Aid Fitter 237600000X 80529 TX
Audiologist 231H00000X 2936 CA Primary
Hearing Instrument Specialist 237700000X 9047 CA

Addresses

Primary practice location

16 E Fern Ave
Ste C
Redlands, CA 92373-4000

Mailing address

16 E Fern Ave
Ste C
Redlands, CA 92373-4000
Phone (909) 792-0074

Other names 1

  • Jessica Marie Rosario Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80529TXMDProfessional Counselor
2936CAMDAudiologist
9047CAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1144661612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 E FERN AVE",
            "address_2": "STE C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734000",
            "telephone_number": "909-792-0074",
            "fax_number": "909-792-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E FERN AVE",
            "address_2": "STE C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734000",
            "telephone_number": "909-792-0074",
            "fax_number": "909-792-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO GONZALEZ",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80529",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "80529",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "2936",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "9047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ROSARIO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.