Individual provider Active NPI

Selena Gonzalez

  • Rehabilitation Practitioner
  • Escondido, CA
National Provider Identifier
1417710070
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
1955 Citracado Pkwy Ste 300
Escondido, CA 92029-4113
Phone
(760) 294-1281
NPI assigned
Feb 5, 2024
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

1955 Citracado Pkwy Ste 300
Escondido, CA 92029-4113

Mailing address

2141 Palomar Airport Rd Ste 350
Carlsbad, CA 92011-1451
Phone (760) 438-0078

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

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1417710070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 PALOMAR AIRPORT RD STE 350",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111451",
            "telephone_number": "760-438-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 CITRACADO PKWY STE 300",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294113",
            "telephone_number": "760-294-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.