Individual provider Active NPI

Clarisa Elizabeth Gonzalez

  • Community Health Worker
  • Long Beach, CA
National Provider Identifier
1710443411
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
3530 Atlantic Ave Ste 210
Long Beach, CA 90807-4569
Phone
(310) 337-1550
NPI assigned
Feb 18, 2019
Last updated
Feb 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA Primary

Addresses

Primary practice location

3530 Atlantic Ave Ste 210
Long Beach, CA 90807-4569

Mailing address

732 W 135TH St
Gardena, CA 90247-2149
Phone (323) 975-1118

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

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1710443411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 W 135TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902472149",
            "telephone_number": "323-975-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 ATLANTIC AVE STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074569",
            "telephone_number": "310-337-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CLARISA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.