Antonio Gonzales

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

2027 Issued in UT

Practice address

3269 S Main St Ste 230
South Salt Lake, UT 84115-3769

Phone

(801) 935-4447

NPI assigned

Apr 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1194346205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 S MAIN ST STE 230",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153769",
            "telephone_number": "801-935-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 S MAIN ST STE 230",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153769",
            "telephone_number": "801-935-4447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4460 S Highland Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841243550",
            "country_code": "US",
            "telephone_number": "888-949-4864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-29",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "UT",
            "license": "2027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Girten, RD
• Bonnie Lyn Given, OTR/L
• Callie Glidden
• Nicolette Lynn Goines, BCBA
• Alethea Goldrup, TRT
• Jennifer Ann Gonzalez, APRN, PMHNP
• Arasu Gopinath, MD
• Rachel Goss, CSW
• Kean Giresse Goue
• Gezanium Goyanes

• Peer Specialist in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Peer Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.