Active NPI
Lisa Gonzales
- Occupational Therapy Assistant
- La Habra, CA
National Provider Identifier
1700155348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 576
- Practice address
- 118 S College St
La Habra, CA 90631-5503 - Phone
- (562) 256-7550
- NPI assigned
- Dec 28, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 576 | CA | Primary |
Addresses
Primary practice location
118 S College St
La Habra, CA 90631-5503
Mailing address
118 S College St
La Habra, CA 90631-5503
Phone (562) 256-7550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 576 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 576 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325030400000",
"number": "1700155348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 S COLLEGE ST",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906315503",
"telephone_number": "562-256-7550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 S COLLEGE ST",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906315503",
"telephone_number": "562-256-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES",
"first_name": "LISA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-28",
"last_updated": "2011-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "576",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "576",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Habra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.