Adriel Jonathan Go, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95022431 Issued in CA

Practice address

4224 Copper Creek Dr
Modesto, CA 95355-8963

Phone

(209) 985-4803

NPI assigned

Nov 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Eag Professional Medical Corp.

  • Psychiatry Physician
  • Ceres, CA
  • NPI 1841483427
  Medicare reassignment NPD

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1669137402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 COPPER CREEK DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558963",
            "telephone_number": "209-985-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 COPPER CREEK DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558963",
            "telephone_number": "209-985-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GO",
        "first_name": "ADRIEL",
        "middle_name": "JONATHAN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-06",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022431",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95196069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyn Glover
• Michaela Glover
• Stephanie Glushenko
• Maree Agnes Glynn, RN
• Sharron Gnos
• Eleuterio Arcangel Go, M.D.
• Jamie Go, MA MFT LMFT
• Maria Go, MD
• Catherine Goddard, MS
• Jastine Rose Marie Godfrey

• Psychiatric/Mental Health Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.