Active NPI
Raul Gonzalez, ATC
- Athletic Trainer
- Santa Ana, CA
National Provider Identifier
1154030153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000039687
- Practice address
- 1417 W Lingan LN Apt 2
Santa Ana, CA 92704-3455 - Phone
- (714) 586-2362
- NPI assigned
- Nov 17, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000039687 | Primary |
Addresses
Primary practice location
1417 W Lingan LN Apt 2
Santa Ana, CA 92704-3455
Mailing address
1417 W Lingan LN Apt 2
Santa Ana, CA 92704-3455
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1154030153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 W LINGAN LN APT 2",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927043455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 W LINGAN LN APT 2",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927043455",
"telephone_number": "714-586-2362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "RAUL",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-17",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": "2000039687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.