Individual provider Active NPI

Kristin Mae Gonzalez, L.AC.

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1164775128
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 14937 Issued in CA
Practice address
5850 Oberlin Drive
Suite 220
San Diego, CA 92121
Phone
(858) 546-1005
Fax
(858) 546-1005
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 14937 CA Primary

Addresses

Primary practice location

5850 Oberlin Drive
Suite 220
San Diego, CA 92121

Mailing address

5850 Oberlin Drive
Suite 220
San Diego, CA 92121
Phone (858) 546-1005

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
AC 14937CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1164775128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 OBERLIN DRIVE",
            "address_2": "SUITE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-546-1005",
            "fax_number": "858-546-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 OBERLIN DRIVE",
            "address_2": "SUITE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-546-1005",
            "fax_number": "858-546-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KRISTIN",
        "middle_name": "MAE",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 14937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.