Ivan Quezada Gonzalez, PHD

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

F7312171 Issued in CA

Practice address

4980 Watt Ave Ste B
North Highlands, CA 95660-5181

Phone

(916) 374-0800

NPI assigned

Feb 13, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1417540139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807",
            "telephone_number": "818-345-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 WATT AVE STE B",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956605181",
            "telephone_number": "916-374-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21600 Oxnard St Ste 1800",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913677807",
            "country_code": "US",
            "telephone_number": "818-345-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21600 Oxnard St Ste 1800",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913677807",
            "country_code": "US",
            "telephone_number": "818-345-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEZADA GONZALEZ",
        "first_name": "IVAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "F7312171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Planned Parenthood Mar Monte, Inc
• Cynthia Pon
• Renae M Provost
• Psynergy Programs, Inc. (Vista Esperanza)
• Karolina Pulber
• Franklin Rafanan, MSW., LCSW
• Gabriel Esteban Ramirez Penaranda, LMFT
• Restore Laboratories Inc.
• Maria Liza Ricafort
• Horatio Marcshaun Ridgeway

• Behavior Technician in North Highlands, CA
• Providers in North Highlands, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.

Verify at the official NPI Registry.