Active NPI
Gerardo M. Gonzalez
- Clinical Psychologist
- Escondido, CA
National Provider Identifier
1154702744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13466
- Practice address
- 145 S Fig St
Escondido, CA 92025-4453 - Phone
- (769) 566-7793
- NPI assigned
- Jun 9, 2015
- Last updated
- Jun 9, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY13466 | CA | |
| Clinical Psychologist | 103TC0700X | PSY13466 | CA | Primary |
Addresses
Primary practice location
145 S Fig St
Escondido, CA 92025-4453
Mailing address
PO Box 1345
San Marcos, CA 92079-1345
Phone (760) 566-7793
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY13466 | CA | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1154702744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1345",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920791345",
"telephone_number": "760-566-7793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 S FIG ST",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920254453",
"telephone_number": "769-566-7793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "GERARDO",
"middle_name": "M.",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-09",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "PSY13466",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.