Individual provider Active NPI

Karen Noemi Gonzalez

  • Occupational Therapy Assistant
  • Mesa, AZ
National Provider Identifier
1255158267
Registry record updated Sep 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-050079 Issued in AZ
Practice address
8916 E Butternut Ave
Mesa, AZ 85208-2351
Phone
(480) 703-8837
NPI assigned
Sep 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-050079 AZ Primary

Addresses

Primary practice location

8916 E Butternut Ave
Mesa, AZ 85208-2351

Mailing address

8916 E Butternut Ave
Mesa, AZ 85208-2351
Phone (480) 703-8837

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
OTA-050079AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1255158267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8916 E BUTTERNUT AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082351",
            "telephone_number": "480-703-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8916 E BUTTERNUT AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082351",
            "telephone_number": "480-703-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KAREN",
        "middle_name": "NOEMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-21",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-050079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; 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.