Jorge Mario Gonzalez Jr.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

250 Executive Park Blvd Ste 4900
San Francisco, CA 94134-3335

Phone

(415) 656-0116

NPI assigned

Jul 2, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Alternative Family Services, Inc

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1811122732
  NPD (past)
• Alternative Family Services, Inc.

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1356591606
  NPD (past)

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1285251504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103917",
            "telephone_number": "415-229-0500",
            "fax_number": "415-647-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 EXECUTIVE PARK BLVD STE 4900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941343335",
            "telephone_number": "415-656-0116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941103917",
            "country_code": "US",
            "telephone_number": "415-229-5000 x542",
            "fax_number": "415-647-3662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JORGE",
        "middle_name": "MARIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-02",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCR",
            "identifier": "CVILLACREZ",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cleryvillacrez@ifrsf.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email address",
            "address_1": "2919 Mission St",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941103917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Isela Gonzalez
• Isela Gonzalez
• Israel Gonzalez
• Jacob Gonzalez, MD
• Jeannie Gonzalez Jr.
• Juana Gonzalez, MBA - HCM
• Karyss Gonzalez
• Kelsey Gonzalez, RDN
• Laura Gonzalez
• Leticia Gonzalez

• Marriage & Family Therapist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.