Individual provider Active NPI

Geraldine Gonzalez Pablo, RPT

  • Specialist
  • Camarillo, CA
National Provider Identifier
1689697591
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT27758 Issued in CA
Practice address
6000 Santa Rosa Rd
Camarillo, CA 93012-7101
Phone
(805) 388-1511
NPI assigned
Jul 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT27758 CA Primary

Addresses

Primary practice location

6000 Santa Rosa Rd
Camarillo, CA 93012-7101

Mailing address

15011 Blackhawk St
Mission Hills, CA 91345-2501
Phone (818) 943-8972

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT27758CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolis Physical Therapy, Inc Past Accepting new patients
Kinetic Therapy Services, a Physical Therapy Corporation Past Accepting new patients

Organizations & group practices 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689697591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15011 BLACKHAWK ST",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913452501",
            "telephone_number": "818-943-8972",
            "fax_number": "818-838-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 SANTA ROSA RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930127101",
            "telephone_number": "805-388-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABLO",
        "first_name": "GERALDINE",
        "middle_name": "GONZALEZ",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT27758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.