Maxine Gonzalez

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1650 Oregon St Ste 104
Redding, CA 96001-1754

Phone

(530) 691-4577

NPI assigned

Sep 14, 2020

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Maxine Demos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1639784853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 OREGON ST STE 104",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011754",
            "telephone_number": "530-691-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 OREGON ST STE 104",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011754",
            "telephone_number": "530-691-4577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3132 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921104421",
            "country_code": "US",
            "telephone_number": "619-683-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MAXINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXINE",
            "last_name": "DEMOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angie Gomez Alvarez
• Vanessa Michelle Gomez
• Kaite Jolean Gonzales, SUDRC
• Elizabeth Margaret Gonzalez, RN
• Joaquin Gonzalez
• Pablo L Gonzalez, DMD
• Good Vibes Psychiatry Nursing Corp.
• Shawn Eugene Goodall, MD
• Daniel M Goodman, MD
• Jennifer Goodman

• Peer Specialist in Redding, CA
• Providers in Redding, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.