Lisa Gonzalez

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19498 Issued in CA

Legal business name

LISA GONZALEZ

Practice address

3446 Park Blvd
San Diego, CA 92103-5209

Phone

(619) 807-2130

NPI assigned

Mar 16, 2015

Organization subpart

No

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

Authorized official

Name

Lisa Gonzalez, L.M.T.

Title

Licensed Massage Therapist

Phone

(619) 807-2130

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1649663527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3446 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035209",
            "telephone_number": "619-807-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3446 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035209",
            "telephone_number": "619-807-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA GONZALEZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LICENSED MASSAGE THERAPIST",
        "authorized_official_telephone_number": "619-807-2130",
        "authorized_official_credential": "L.M.T."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "19498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIGNA",
            "identifier": "U2298533104",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.