Individual provider Active NPI

Lizet Gonzalez

  • Marriage & Family Therapist
  • Fullerton, CA
National Provider Identifier
1205381092
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF101784 Issued in CA
Practice address
801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846
Phone
(714) 680-9000
Fax
(714) 680-8233
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF101784 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

801 E Chapman Ave Ste 203
Fullerton, CA 92831-3846

Mailing address

PO Box 919
Fullerton, CA 92836-0919
Phone (714) 680-9000

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
IMF101784CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crittenton Services Past Accepting new patients
Thrive Community Family Therapy Services Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1205381092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928360919",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E CHAPMAN AVE STE 203",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313846",
            "telephone_number": "714-680-9000",
            "fax_number": "714-680-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LIZET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF101784",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.