Santiago Gonzalez IV, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

AMFT110202 Issued in CA

Practice address

460 N Magnolia Ave Ste 110
El Cajon, CA 92020-3610

Phone

(619) 440-5133

NPI assigned

Mar 8, 2017

Sex

Male

Sole proprietor

No

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

Locations

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.

• Bold Health Medical Group, a Professional Corporation

  dba Bold Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Encinitas, CA
  • NPI 1245749688
  NPD
• Community Research Foundation Inc

  dba Hawthorne Crisis Center

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1225251812
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700
  NPD (past)
• Community Research Foundation, Inc.

  dba Heartland Wellness Recovery Center

  • Community/Behavioral Health Agency
  • El Cajon, CA
  • NPI 1649342866

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386185411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 N MAGNOLIA AVE STE 110",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203610",
            "telephone_number": "619-440-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MAGNOLIA AVE STE 110",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203610",
            "telephone_number": "619-440-5133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Laurel St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921011634",
            "country_code": "US",
            "telephone_number": "619-233-4399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "561 Saxony Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "92024",
            "country_code": "US",
            "telephone_number": "760-503-4703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SANTIAGO",
        "name_suffix": "IV",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-08",
        "last_updated": "2022-07-21",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110202",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT110202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graciela Denice Gonzalez, BS
• Jill Elisabeth Gonzalez
• Josue Alexander Gonzalez
• Martin Gonzalez
• Samantha Elena Gonzalez
• Sofia Gonzalez, MEDICAL ASSISTANT
• Unyke Maricela Gonzalez
• Good Samaritan Retirement Center
• Gregory Mathew Good
• Camille Goodin

• Mental Health Counselor in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.