Individual provider Active NPI

Flavio A Gonzalez

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1407613920
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95028765 Issued in CA
Practice address
7045 N Maple Ave Ste 108
Fresno, CA 93720-8008
Phone
(559) 746-9605
NPI assigned
Mar 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NP95028765 CA
Nurse Practitioner 363L00000X 95028765 CA Primary

Addresses

Primary practice location

7045 N Maple Ave Ste 108
Fresno, CA 93720-8008

Mailing address

820 S Akers St Ste 120
Visalia, CA 93277-8306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710002085 CA Practitioner - Nurse Practitioner 2264977685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1313 E Herndon Ave
Suite 101B/202 207/209
Fresno, CA 93720-3306
Phone (559) 439-6808

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95028765CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group Family Medicine CurrentSince May 1, 2025 Accepting new patients
Community Foundation Medical Group CurrentSince May 1, 2025 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Bass Medical Group Family Medicine Past Accepting new patients

Locations

7014 N Whitney Ave
Fresno, CA 93720
Phone (559) 321-2800

1313 E Herndon Ave
Ste 101B102
Fresno, CA 93720

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

1313 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 439-6808

1313 E Herndon Ave
Ste 101B20220
Fresno, CA 93720

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1407613920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S AKERS ST STE 120",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7045 N MAPLE AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208008",
            "telephone_number": "559-746-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "FLAVIO",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-01",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "NP95028765",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95028765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.