Active NPI
Nichole Gonzales
- Clinical Psychologist
- Encino, CA
National Provider Identifier
1548712110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSB94023047
- Practice address
- 16661 Ventura Blvd Ste 400-F
Encino, CA 91436-1914 - Phone
- (310) 985-1160
- NPI assigned
- Oct 31, 2016
- 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 | PSB94023047 | CA | Primary |
Addresses
Primary practice location
16661 Ventura Blvd Ste 400-F
Encino, CA 91436-1914
Mailing address
802 Citrus CT
Claremont, CA 91711-1503
Phone (562) 201-4751
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSB94023047 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477872000000",
"number": "1548712110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 CITRUS CT",
"city": "CLAREMONT",
"state": "CA",
"postal_code": "917111503",
"telephone_number": "562-201-4751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16661 VENTURA BLVD STE 400-F",
"city": "ENCINO",
"state": "CA",
"postal_code": "914361914",
"telephone_number": "310-985-1160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "NICHOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-31",
"last_updated": "2016-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSB94023047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.