Active NPI
Angelica Gonzalez
- Community Health Worker
- Lebanon, OR
National Provider Identifier
1356733430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 100 Mullins Dr Ste A1
Lebanon, OR 97355-2868 - Phone
- (541) 766-0200
- NPI assigned
- Feb 25, 2015
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Community Health Worker | 172V00000X | OR | Primary |
Addresses
Primary practice location
100 Mullins Dr Ste A1
Lebanon, OR 97355-2868
Mailing address
2435 Greenway Dr NE
Salem, OR 97301-4535
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion County Health Department | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Salem, OR
- NPI 1487881959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1356733430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2435 GREENWAY DR NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973014535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MULLINS DR STE A1",
"city": "LEBANON",
"state": "OR",
"postal_code": "973552868",
"telephone_number": "541-766-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ANGELICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-25",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.