Individual provider Active NPI

Marie Charlotte C. Gonzales, P.T.

  • Physical Therapist
  • Rancho Cucamonga, CA
National Provider Identifier
1174648331
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28951 Issued in CA
Practice address
9190 Haven Ave
Suite 100 & 240
Rancho Cucamonga, CA 91730-5431
Phone
(615) 778-4066
Fax
(615) 778-9114
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 28951 CA Primary

Addresses

Primary practice location

9190 Haven Ave
Suite 100 & 240
Rancho Cucamonga, CA 91730-5431

Mailing address

720 Cool Springs Blvd
Suite 300
Franklin, TN 37067-2626
Phone (615) 778-4066

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
28951CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174648331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COOL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672626",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9190 HAVEN AVE",
            "address_2": "SUITE 100 & 240",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305431",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "MARIE CHARLOTTE",
        "middle_name": "C.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "28951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.