Individual provider Active NPI

Ana Lucia Gonzalez Herrera

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1710557046
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
57.251187 Issued in OH
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-1000
NPI assigned
Jun 29, 2021
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 57.251187 OH Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

11905 Mayfield Rd Unit 505
Cleveland, OH 44106-2986
Phone (520) 637-0971

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Allscripts
CONNECT URL Epic

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

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1710557046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 MAYFIELD RD UNIT 505",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441062986",
            "telephone_number": "520-637-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ HERRERA",
        "first_name": "ANA",
        "middle_name": "LUCIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.251187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Allscripts",
            "affiliation": "N",
            "address_1": "11100 Euclid Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "address_1": "1919 E Thomas Rd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850167710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.