Individual provider Active NPI

Angela Marie Gonzale, PHARM D

  • Pharmacist
  • Santa Fe, NM
National Provider Identifier
1619224359
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP00007876 Issued in NM
Practice address
1096 S Saint Francis Dr
Santa Fe, NM 87505-1654
Phone
(505) 982-9811
Fax
(505) 982-1072
NPI assigned
Aug 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00007876 NM Primary

Addresses

Primary practice location

1096 S Saint Francis Dr
Santa Fe, NM 87505-1654

Mailing address

2311 Camino Haulapai
Santa Fe, NM 87505-6265
Phone (505) 692-1025

Other names 1

  • Angela Jaber Other name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RP00007876NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1619224359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 CAMINO HAULAPAI",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056265",
            "telephone_number": "505-692-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 S SAINT FRANCIS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051654",
            "telephone_number": "505-982-9811",
            "fax_number": "505-982-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALE",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00007876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "JABER",
            "credential": "PHARM D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.