Individual provider Active NPI

Danielle Samantha Gonzales

  • Marriage & Family Therapist
  • San Bernardino, CA
National Provider Identifier
1700569969
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
163531 Issued in CA
Practice address
325 W Hospitality LN Ste 112
San Bernardino, CA 92408-3211
Phone
(909) 522-4656
NPI assigned
Aug 14, 2023
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 163531 CA Primary

Addresses

Primary practice location

325 W Hospitality LN Ste 112
San Bernardino, CA 92408-3211

Mailing address

325 W Hospitality LN Ste 112
San Bernardino, CA 92408-3211
Phone (909) 522-4656

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
163531CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Community Support Services, Inc PastSince Apr 27, 2025 Accepting new patients
Victor Community Support Services, Inc. PastSince Feb 9, 2025 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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1700569969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W HOSPITALITY LN STE 112",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083211",
            "telephone_number": "909-522-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W HOSPITALITY LN STE 112",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083211",
            "telephone_number": "909-522-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "DANIELLE",
        "middle_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "163531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.