Kristin Detwiler Gonzalez

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25600 Issued in CA

Practice address

23430 Hawthorne Blvd
BLDG 3 Suite 105
Torrance, CA 90505-4720

Phone

(310) 465-2455

NPI assigned

Mar 23, 2006

Last updated

Mar 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD
• Pearl Chiropractic Inc

  • Chiropractor
  • Long Beach, CA
  • NPI 1871105031
  NPD (past)
• Women's Advantage Physical Therapy Inc

  • Orthopedic Physical Therapist
  • Torrance, CA
  • NPI 1396054953
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1598725608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD",
            "address_2": "BLDG 3 SUITE 105",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD",
            "address_2": "BLDG 3 SUITE 105",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054720",
            "telephone_number": "310-465-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KRISTIN",
        "middle_name": "DETWILER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "225100000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose David Gonzalez
• Joshua Gonzalez
• Kalesha Gonzalez Gonzalez, IDMT
• Karen Gonzalez
• Kimberly Denise Gonzalez
• Laura Estephany Gonzalez
• Lilliana Gonzalez
• Lorenzo Antonio Gonzalez, MD MPL
• Melissa Lizzette Gonzalez
• Milagro Guadalupe Gonzalez

• Physical Therapist in Torrance, CA
• Providers in Torrance, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.