Active NPI
Jacob Gonzalez, MA
- School Psychologist
- Las Cruces, NM
National Provider Identifier
1255175147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 800 S Walnut St
Las Cruces, NM 88001-3954 - Phone
- (575) 526-2819
- NPI assigned
- Jun 24, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
800 S Walnut St
Las Cruces, NM 88001-3954
Mailing address
1425 Wyoming Ave Apt 4
Las Cruces, NM 88001-5759
Phone (915) 777-9023
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Casa, Inc. | Current | Accepting new patients |
Locations
800 S Walnut St
Las Cruces, NM 88001
Phone (575) 526-2819
Organizations & group practices 1
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.
-
- Counselor
- Las Cruces, NM
- NPI 1750009627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1255175147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 WYOMING AVE APT 4",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880015759",
"telephone_number": "915-777-9023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S WALNUT ST",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880013954",
"telephone_number": "575-526-2819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JACOB",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-24",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.