Individual provider Active NPI

Jairo Gonzalez, PTA

  • Physical Therapy Assistant
  • Oceanside, CA
National Provider Identifier
1669271664
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
53836 Issued in CA
Practice address
713 Mission Ave Ste B
Oceanside, CA 92054-2852
Phone
(760) 453-7072
Fax
(844) 269-6815
NPI assigned
Mar 11, 2025
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 53836 CA Primary

Addresses

Primary practice location

713 Mission Ave Ste B
Oceanside, CA 92054-2852

Mailing address

713 Mission Ave Ste B
Oceanside, CA 92054-2852
Phone (760) 453-7072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Craig-Jones and Flynn Physical Therapy PC CurrentSince Mar 20, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1669271664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MISSION AVE STE B",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542852",
            "telephone_number": "760-453-7072",
            "fax_number": "844-269-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 MISSION AVE STE B",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920542852",
            "telephone_number": "760-453-7072",
            "fax_number": "844-269-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JAIRO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "53836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.