Individual provider Active NPI

Nicolette Gonzalez, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1265007819
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63835 Issued in CA
Practice address
3900 5TH Ave
San Diego, CA 92103-3121
Phone
(858) 554-1212
NPI assigned
May 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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 PA63835 CA Primary

Addresses

Primary practice location

3900 5TH Ave
San Diego, CA 92103-3121

Mailing address

310 A St Apt 2102
San Diego, CA 92101-4323
Phone (619) 751-7765

Other practice location 1

4723 W Main St Ste H
Guadalupe, CA 93434-1787
Phone (805) 343-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206000883 CA Practitioner - Physician Assistant 7810330909 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

10538 Mission Gorge Rd
Suite 100
Santee, CA 92071-3154
Phone (619) 456-0033

1740 Rosecrans St
San Diego, CA 92106-1928
Phone (619) 790-7800

1905 Calle Barcelona
Suite 211
Carlsbad, CA 92009-8452
Phone (858) 766-6007

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

4142 Adams Ave
Suite 102
San Diego, CA 92116-2593
Phone (858) 617-0717

4275 Mission Bay Dr
San Diego, CA 92109-5775

750 Otay Lakes Rd
Suite 272
Chula Vista, CA 91910-6915

752 Medical Ctr CT
Suite 200
Chula Vista, CA 91911-6659
Phone (619) 421-4311

760 Otay Lakes Rd
Chula Vista, CA 91910-6915
Phone (619) 821-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA63835CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Somagen Healthcare Inc CurrentSince Oct 22, 2024 Accepting new patients
SD Sports Medicine and Family Health Center CurrentSince Dec 1, 2025 Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group PastSince Aug 4, 2024 Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Regents of the University of California Past Accepting new patients
Somagen Healthcare Inc Past Accepting new patients
Regents of the University of California PastSince Aug 4, 2024 Accepting new patients
Somagen Healthcare Inc Past Accepting new patients

Locations

750 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 259-9462

760 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 821-2300

8260 Mira Mesa Blvd
Ste A
San Diego, CA 92126
Phone (855) 362-9773

1945 Garnet Ave
San Diego, CA 92109
Phone (858) 224-7977

8590 Rio San Diego Dr
Ste 111
San Diego, CA 92108
Phone (619) 736-4600

6699 Alvarado Rd
Ste 2100
San Diego, CA 92120
Phone (619) 229-3909

1740 Rosecrans St
San Diego, CA 92106
Phone (619) 790-7800

5671 Balboa Ave
San Diego, CA 92111
Phone (855) 362-9773

10505 Sorrento Valley Rd
Ste 200
San Diego, CA 92121
Phone (858) 793-7860

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1265007819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 A ST APT 2102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014323",
            "telephone_number": "619-751-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 5TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033121",
            "telephone_number": "858-554-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4723 W Main St Ste H",
            "address_purpose": "LOCATION",
            "city": "Guadalupe",
            "state": "CA",
            "postal_code": "934341787",
            "country_code": "US",
            "telephone_number": "805-343-5577",
            "fax_number": "805-343-5578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "NICOLETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.