Jennifer Patricia Gonzales

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

160 Wikiup Dr Ste 102
Santa Rosa, CA 95403-7776

Phone

(707) 483-3745

NPI assigned

Sep 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1336624915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WIKIUP DR STE 102",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954037776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WIKIUP DR STE 102",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954037776",
            "telephone_number": "707-483-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JENNIFER",
        "middle_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "12575826",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santiago Gomez
• Ulysses Gomez, M.D.
• Derek Patrick Gong, M.D.
• Gail Gonick-Hallows, M.A.
• Francesca R Gonnella, LCSW
• Mark Gonzales
• Sara Marie Gonzales, SUDCR
• Paul Cesar Gonzalez Hernandez
• Maria Geogina Gonzalez Leou, LCSW
• Julissa Gonzalez Maccall

• Specialist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.