Jan Gonzales

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

6577 Issued in CA

Practice address

36 Mauchly Ste a
Irvine, CA 92618-2390

Phone

(949) 727-3315

Fax

(949) 727-3624

NPI assigned

Apr 22, 2021

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1215519905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 408",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858",
            "telephone_number": "310-856-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MAUCHLY STE A",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182390",
            "telephone_number": "949-727-3315",
            "fax_number": "949-727-3624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2670 N Main St",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927056639",
            "country_code": "US",
            "telephone_number": "949-357-2556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "6577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Partha Gonavaram, MD
• Flannery A Gonneville
• Susan Ann Gonzales Crandall, LCSW
• Gizelle Espiritu Santo Gonzales, RNFA
• Jacquelyn Gonzales, NP
• Michael Frank Gonzales, PH.D.
• Maria Jose Gonzalez Ramirez
• Aida Raquel Gonzalez
• Alyssa Evelia Gonzalez
• Anthony Charles Gonzalez, BA

• Occupational Therapy Assistant in Irvine, CA
• Providers in Irvine, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.