Active NPI
Berenice Gonzalez, PSY.D.
- Clinical Psychologist
- Covina, CA
National Provider Identifier
1548391865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY30717
- Practice address
- 1359 N Grand Ave
Covina, CA 91724-1016 - Phone
- (626) 430-2900
- NPI assigned
- Mar 8, 2007
- 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 Psychologist | 103TC0700X | PSY30717 | CA | Primary |
Addresses
Primary practice location
1359 N Grand Ave
Covina, CA 91724-1016
Mailing address
PO Box 94
Covina, CA 91723-0094
Phone (626) 869-8090
Other practice location 1
750 Terrado Plz Ste 104
Covina, CA 91723-3411
Phone (626) 859-2089 ext. 123
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY30717 | CA | MD | Clinical Psychologist |
| 30717 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1548391865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 94",
"city": "COVINA",
"state": "CA",
"postal_code": "917230094",
"telephone_number": "626-869-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1359 N GRAND AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917241016",
"telephone_number": "626-430-2900"
}
],
"practiceLocations": [
{
"address_1": "750 Terrado Plz Ste 104",
"address_purpose": "LOCATION",
"city": "Covina",
"state": "CA",
"postal_code": "917233411",
"country_code": "US",
"telephone_number": "626-859-2089 x123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALEZ",
"first_name": "BERENICE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY30717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.