Active NPI
Jesica Gonzalez
- Clinical Social Worker
- Hayward, CA
National Provider Identifier
1265063887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 117566
- Practice address
- 21455 Birch St
Hayward, CA 94541-2165 - Phone
- (510) 600-7320
- NPI assigned
- Feb 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 117566 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | 90834 | CA |
Addresses
Primary practice location
21455 Birch St
Hayward, CA 94541-2165
Mailing address
21455 Birch St
Hayward, CA 94541-2165
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
| License | State | Type | Specialty |
|---|---|---|---|
| 117566 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1265063887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21455 BIRCH ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945412165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21455 BIRCH ST",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945412165",
"telephone_number": "510-600-7320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JESICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-01",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "117566",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "90834",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.