Ivan Martinez Gonzalez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113824 Issued in CA

Practice address

162 E Carson St Ste B
Colusa, CA 95932-2880

Phone

(530) 458-0520

Fax

(530) 458-7751

NPI assigned

Mar 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Colusa

  • Community/Behavioral Health Agency
  • Colusa, CA
  • NPI 1902929052
  Medicare reassignment NPD
• Colusa County Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Colusa, CA
  • NPI 1558982389
  NPD
• County of Tehama

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Red Bluff, CA
  • NPI 1467668616
  NPD (past)

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1497250351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 E CARSON ST STE B",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322880",
            "telephone_number": "530-458-0520",
            "fax_number": "530-458-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 E CARSON ST STE B",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322880",
            "telephone_number": "530-458-0520",
            "fax_number": "530-458-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ GONZALEZ",
        "first_name": "IVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Carmen Lopez
• Victor Lyapis, M.D.
• Ivet Madrigal
• Sharon Maguire
• Yolanda Martinez de Sigala
• Rocio Martinez
• Jennifer Lynn McAllister, MFT
• Delia McDonald
• Mark Westley McGregor
• Samuel Medrano, M.D.

• Clinical Social Worker in Colusa, CA
• Providers in Colusa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.

Verify at the official NPI Registry.