Mitzi Michelle Gonzales, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY28558 Issued in CA

Practice address

444 S San Vicente Blvd Ste 103
Los Angeles, CA 90048-4169

Phone

(310) 423-9722

Fax

(310) 248-8710

NPI assigned

Apr 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

University of Texas at Austin Dell Medical School, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score

93.23 of 100Reported as group

Quality

77.83

Promoting interoperability

98

Improvement activities

40

Cost

71.17

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment NPD
• Cedars-Sinai Medical Center

  dba San Vicente Pharmacy

  • Pharmacy
  • Los Angeles, CA
  • NPI 1376514810
  NPD
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  dba UTHSCSA Dental School

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1760424873
  NPD
• Cedars-Sinai Medical Center

  • Registered Dietitian
  • West Hollywood, CA
  • NPI 1083785489
  NPD (past)
• Bexar County Hospital District

  dba University Health Dialysis Southeast

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Antonio, TX
  • NPI 1164592531
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  Care Compare affiliation
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • West Hollywood, CA
  • NPI 1891940326
  Care Compare affiliation

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1659806123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S SAN VICENTE BLVD STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484169",
            "telephone_number": "310-423-9722",
            "fax_number": "310-248-8710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8300 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78229",
            "country_code": "US",
            "telephone_number": "210-450-9700",
            "fax_number": "210-450-6039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8700 Beverly Blvd Ste 7409",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-3933",
            "fax_number": "310-248-8710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "MITZI",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "36697",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY28558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382200901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "382200902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Sistoso Gonzales, NP-C, FNP-BC
• Jonathan Frank Gonzales
• Joseph Anthony Gonzales
• Kristin Nicole Varilla Gonzales, BA
• Kyle Anthony Gonzales, DNP, PMHNP-BC, RN
• Nikko Rosca Gonzales
• Rachelle Ann Lopez Gonzales, MD
• Raul Gonzales
• Richard Joseph Gonzales Sr., PHYSICIAN ASSISTANT
• Rommel Gonzales, MD

• Clinical Neuropsychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.