Active NPI
Jessica Nichole Gonzalez, LCSW
- Clinical Social Worker
- Fullerton, CA
National Provider Identifier
1467290650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 90452
- Practice address
- 140 E Commonwealth Ave Ste 208
Fullerton, CA 92832-1905 - Phone
- (949) 610-8966
- Fax
- (530) 767-4355
- NPI assigned
- Jul 19, 2024
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 90452 | CA | Primary |
Addresses
Primary practice location
140 E Commonwealth Ave Ste 208
Fullerton, CA 92832-1905
Mailing address
725 S Grand Ave
Glendora, CA 91740-4141
Phone (626) 691-1700
Other practice location 1
4160 Temescal Canyon Rd Ste 205
Corona, CA 92883-4624
Phone (858) 279-1223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90452 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Glendora, CA
- NPI 1831338193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1467290650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 S GRAND AVE",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404141",
"telephone_number": "626-691-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 E COMMONWEALTH AVE STE 208",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321905",
"telephone_number": "949-610-8966",
"fax_number": "530-767-4355"
}
],
"practiceLocations": [
{
"address_1": "4160 Temescal Canyon Rd Ste 205",
"address_purpose": "LOCATION",
"city": "Corona",
"state": "CA",
"postal_code": "928834624",
"country_code": "US",
"telephone_number": "858-279-1223",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JESSICA",
"middle_name": "NICHOLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-19",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "90452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.