Yael Gonicman

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

120198 Issued in CA

Practice address

355 Gellert Blvd Ste 257
Daly City, CA 94015-2676

Phone

(628) 242-2662

NPI assigned

Jun 8, 2017

Last updated

Feb 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Izzo Marriage and Family Therapy PCGroup PAC ID 5092249490, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Izzo Marriage & Family Therapy PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Mateo, CA
  • NPI 1518557552
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1144759556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ROCK HARBOR LN",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944043569",
            "telephone_number": "858-337-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GELLERT BLVD STE 257",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152676",
            "telephone_number": "628-242-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 South Amphlett Blvd.",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "94002",
            "country_code": "US",
            "telephone_number": "650-877-8642 x20",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONICMAN",
        "first_name": "YAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "120198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Gate Radiology Medical Group, Inc
• Golden Heights Operations LLC (Golden Heights Healthcare)
• Golden Pavilion Operations LLC (Golden Pavilion Healthcare)
• Noel D Goldthwaite, MD
• Jacqueline Gomez
• Karina Gonzales Vazquez
• Aris Marc Adel Gonzales, LVN
• Andy Gonzalez de Leon
• Rafael Gonzalez Hidalgo
• Dilan Gonzalez Rodas

• Marriage & Family Therapist in Daly City, CA
• Providers in Daly City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.