Individual provider Active NPI

Paola Adelaida Gonzalez, M.ED., B.C.B.A.

  • Behavior Analyst
  • San Diego, CA
National Provider Identifier
1710258322
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1118194 Issued in CA
Practice address
10065 Old Grove Rd Ste 200
San Diego, CA 92131-1664
Phone
(858) 444-8823
Fax
(858) 444-8827
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1118194 CA Primary

Addresses

Primary practice location

10065 Old Grove Rd Ste 200
San Diego, CA 92131-1664

Mailing address

10065 Old Grove Rd Ste 200
San Diego, CA 92131-1664
Phone (858) 444-8823

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
1118194CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1710258322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10065 OLD GROVE RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311664",
            "telephone_number": "858-444-8823",
            "fax_number": "858-444-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10065 OLD GROVE RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311664",
            "telephone_number": "858-444-8823",
            "fax_number": "858-444-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "PAOLA",
        "middle_name": "ADELAIDA",
        "credential": "M.ED., B.C.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1118194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.