Individual provider Active NPI

Estevan Gonzalez

  • Addiction (Substance Use Disorder) Counselor
  • Lake Elsinore, CA
National Provider Identifier
1477272847
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1563750624 Issued in CA
Practice address
31764 Casino Dr Ste 200
Lake Elsinore, CA 92530-2312
Phone
(951) 471-4649
NPI assigned
Aug 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X R1563750624 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X R1563750624 CA Primary
Peer Specialist 175T00000X MPSS-PDNXEL CA

Addresses

Primary practice location

31764 Casino Dr Ste 200
Lake Elsinore, CA 92530-2312

Mailing address

31764 Casino Dr Ste 200
Lake Elsinore, CA 92530-2312
Phone (951) 471-4649

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
R1563750624CAMDAddiction (Substance Use Disorder) Counselor
MPSS-PDNXELCAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1477272847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR STE 200",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312",
            "telephone_number": "951-471-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR STE 200",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312",
            "telephone_number": "951-471-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ESTEVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-26",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "R1563750624",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1563750624",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-PDNXEL",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.