Individual provider Active NPI

Priscilla Gonzalez, CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1205718194
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
39898 Issued in CA
Practice address
3880 Nobel Dr
San Diego, CA 92122-5700
Phone
(847) 441-5593
NPI assigned
Jul 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 39898 CA Primary

Addresses

Primary practice location

3880 Nobel Dr
San Diego, CA 92122-5700

Mailing address

1035 27TH St
San Diego, CA 92154-2103
Phone (619) 549-2849

Other practice location 1

3535 Manchester Ave
Cardiff, CA 92007-1520
Phone (847) 441-5593 ext. 1181

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
39898CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Speech Services Speech-Language Pathologist CurrentSince Jul 28, 2025 Accepting new patients
Rehabcare Group East, LLC PastSince Jul 28, 2025 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": "1753142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1205718194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 27TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921542103",
            "telephone_number": "619-549-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 NOBEL DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225700",
            "telephone_number": "847-441-5593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Manchester Ave",
            "address_purpose": "LOCATION",
            "city": "Cardiff",
            "state": "CA",
            "postal_code": "920071520",
            "country_code": "US",
            "telephone_number": "847-441-5593 x1181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "PRISCILLA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "39898",
            "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 Jul 22, 2025; 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.