Active NPI
Maritess Gonzales Ganz, PT
- Physical Therapist
- San Leandro, CA
National Provider Identifier
1184007049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38557
- Practice address
- 101 Callan Ave
San Leandro, CA 94577 - Phone
- (510) 357-4222
- NPI assigned
- Jul 9, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 38557 | CA | Primary |
Addresses
Primary practice location
101 Callan Ave
San Leandro, CA 94577
Mailing address
3300 Bowman St
Philadelphia, PA 19129
Phone (505) 414-8158
Other names 1
- Maritess Mallari Gonzales
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 |
|---|---|---|---|
| 38557 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436400000000",
"number": "1184007049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 BOWMAN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19129",
"telephone_number": "505-414-8158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CALLAN AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "94577",
"telephone_number": "510-357-4222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANZ",
"first_name": "MARITESS",
"middle_name": "GONZALES",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2015-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "38557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARITESS",
"last_name": "GONZALES",
"middle_name": "MALLARI",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.