Jerome D Gonzales, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT9790 Issued in CA

Practice address

5125 Monte Vista St
Los Angeles, CA 90042-3931

Phone

(323) 254-6125

NPI assigned

Nov 20, 2009

Last updated

Jan 6, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

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  NPD (past)
• SM Rehab Inc

  • Occupational Therapist
  • Anaheim, CA
  • NPI 1760778393
  NPD (past)

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1659609188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 MONTE VISTA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900423931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 MONTE VISTA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900423931",
            "telephone_number": "323-254-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JEROME",
        "middle_name": "D",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-20",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT9790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OT9790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Gonzales, RAD-T 1
• Jeannie Gonzales, ATC
• Jeneva Gonzales
• Jennifer Barba Gonzales, PA-C
• Jennilyn Gonzales
• Jesse Ray Gonzales
• Jocelyn Sistoso Gonzales, NP-C, FNP-BC
• Jonathan Frank Gonzales
• Joseph Anthony Gonzales
• Kristin Nicole Varilla Gonzales, BA

• Occupational Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.