Individual provider Active NPI

Crista Gonzalez, LEP

  • Psychologist
  • Redondo Beach, CA
National Provider Identifier
1437807674
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LEP3469 Issued in CA
Practice address
116 S Catalina Ave Ste 118
Redondo Beach, CA 90277-3388
Phone
(310) 367-2368
NPI assigned
Mar 16, 2022
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Psychologist 103T00000X LEP3469 CA Primary
Counseling Psychologist 103TC1900X LEP3469 CA
Counseling Psychologist 103TC1900X 3469 CA
School Psychologist 103TS0200X 3469 CA

Addresses

Primary practice location

116 S Catalina Ave Ste 118
Redondo Beach, CA 90277-3388

Mailing address

5110 Patrick St
Torrance, CA 90503-1931
Phone (310) 367-2368

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

State licenses

LicenseStateTypeSpecialty
LEP3469CAMDCounseling Psychologist
3469CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crista Gonzalez Educational Psychology Inc School CurrentSince Nov 9, 2025 Accepting new patients
CKM Clinical Consulting Inc. PastSince Mar 1, 2022 Accepting new patients

Locations

116 S Catalina Ave
Ste 118
Redondo Beach, CA 90277
Phone (310) 367-2368

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1437807674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 PATRICK ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031931",
            "telephone_number": "310-367-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S CATALINA AVE STE 118",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773388",
            "telephone_number": "310-367-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CRISTA",
        "credential": "LEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "LEP3469",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "LEP3469",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "3469",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "3469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.