Active NPI
Stephanie Gonzales
- Community Health Worker
- Espanola, NM
National Provider Identifier
1467078873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 2010 Industrial Park Rd
Espanola, NM 87532-3600 - Phone
- (505) 753-3143
- NPI assigned
- Jun 22, 2020
- Last updated
- Jun 22, 2020
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
2010 Industrial Park Rd
Espanola, NM 87532-3600
Mailing address
PO Box 94508
Albuquerque, NM 87199-4508
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": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1467078873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 94508",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871994508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 INDUSTRIAL PARK RD",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875323600",
"telephone_number": "505-753-3143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.