NPIMap

Individual provider Active NPI

Veronica A Gonzales, PA

  • Physician Assistant
  • San Rafael, CA
National Provider Identifier
1245329606
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12489 Issued in CA
Practice address
36 Rustic Way
San Rafael, CA 94901-1118
Phone
(925) 779-9709
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12489 CA Primary

Addresses

Primary practice location

36 Rustic Way
San Rafael, CA 94901-1118

Mailing address

36 Rustic Way
San Rafael, CA 94901-1118
Phone (925) 779-9709

Other identifiers 3

IdentifierTypeStateIssuer
318979600OtherCADEPARTMENT OF LABOR
970013241OtherCARAILROAD PROVIDER NUMBER
OPA124890OtherCAMC PTAN

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA12489CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peter a Von Rogov Mda Professional Corporation Past Accepting new patients
Peled Plastic Surgery Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Gordon C. Lundy Past Accepting new patients
North Bay Surgical Group Past Accepting new patients
Gordon C Lundy MD a Professional Corporation Past Accepting new patients

Organizations & group practices 6

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1245329606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RUSTIC WAY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011118",
            "telephone_number": "925-779-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 RUSTIC WAY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011118",
            "telephone_number": "925-779-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "VERONICA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "318979600",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PROVIDER NUMBER",
            "identifier": "970013241",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PTAN",
            "identifier": "OPA124890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.