Active NPI
Jesus Abraham Gonzalez
- Psychologist
- San Diego, CA
National Provider Identifier
1609590587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 2285 River Run Dr Apt 8102
San Diego, CA 92108-5851 - Phone
- (619) 302-8949
- NPI assigned
- Oct 3, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
2285 River Run Dr Apt 8102
San Diego, CA 92108-5851
Mailing address
2285 River Run Dr Apt 8102
San Diego, CA 92108-5851
Phone (619) 302-8949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12970485 | Other | MEXICAN BOARD OF PSHYCOLOGISTS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | KAISER | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1609590587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2285 RIVER RUN DR APT 8102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921085851",
"telephone_number": "619-302-8949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2285 RIVER RUN DR APT 8102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921085851",
"telephone_number": "619-302-8949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JESUS",
"middle_name": "ABRAHAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-03",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEXICAN BOARD OF PSHYCOLOGISTS",
"identifier": "12970485",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "KAISER",
"affiliation": "N",
"endpointDescription": "KAISER",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2285 River Run Dr Apt 8102",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921085851",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.