Rachael Gordon, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202108915NP-PP Issued in OR

Practice address

6276 San Ignacio Ave Ste a
San Jose, CA 95119-1363

Phone

(541) 313-3617

Fax

(769) 235-0747

NPI assigned

Aug 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Southern Oregon Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Medford, OR
  • NPI 1114695962
  NPD Authorized official

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1306327507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047029",
            "telephone_number": "541-313-3617",
            "fax_number": "769-235-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 SAN IGNACIO AVE STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191363",
            "telephone_number": "541-313-3617",
            "fax_number": "769-235-0747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975013135",
            "country_code": "US",
            "telephone_number": "541-313-3617",
            "fax_number": "769-235-0747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "RACHAEL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95042892",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202108915NP-PP",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95013365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin O. Gordon, MD
• Camille Gordon
• Linda M Gordon, M.D.
• Lisa A Gordon, DMD
• Malcolm Gordon, MD
• Rosa Gorel-Wong
• Joe A Gorelick, N.P
• Tyler Gorenflo
• Anne Marie Goris, M.D.
• Jennifer Gorman

• Psychiatric/Mental Health Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.