Active NPI
Jennifer Barba Gonzales, PA-C
- Family Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1396877494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP578079
- Practice address
- 1701 E Cesar E Chavez Ave
Suite 402
Los Angeles, CA 90033-2464 - Phone
- (323) 317-9200
- Fax
- (323) 317-9206
- NPI assigned
- Mar 12, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP578079 | CA | Primary |
Addresses
Primary practice location
1701 E Cesar E Chavez Ave
Suite 402
Los Angeles, CA 90033-2464
Mailing address
1701 E Cesar E Chavez Ave
Suite 402
Los Angeles, CA 90033-2464
Phone (323) 317-9200
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP578079 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1396877494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 E CESAR E CHAVEZ AVE",
"address_2": "SUITE 402",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900332464",
"telephone_number": "323-317-9200",
"fax_number": "323-317-9206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E CESAR E CHAVEZ AVE",
"address_2": "SUITE 402",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900332464",
"telephone_number": "323-317-9200",
"fax_number": "323-317-9206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "JENNIFER",
"middle_name": "BARBA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP578079",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "25825 Vermont Ave",
"city": "Harbor City",
"state": "CA",
"country_code": "US",
"postal_code": "907103518",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.