Active NPI
Marissalyn Gonzales
- Behavior Analyst
- Albuquerque, NM
National Provider Identifier
1720588411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-29099
- Practice address
- 500 Marquette Ave NW Ste 1200
Albuquerque, NM 87102-5312 - Phone
- (855) 832-6727
- Fax
- (772) 675-9100
- NPI assigned
- Feb 19, 2018
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-17-29099 | CA | Primary |
Addresses
Primary practice location
500 Marquette Ave NW Ste 1200
Albuquerque, NM 87102-5312
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727
Other practice location 1
2928 Jefferson St Ste 100
Carlsbad, CA 92008-2374
Phone (855) 223-7123
Other practice location 2
725 S Mesa Hills Dr Bldg 3
El Paso, TX 79912-5568
Phone (855) 223-7123
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": "1518998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1720588411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727",
"fax_number": "772-675-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 MARQUETTE AVE NW STE 1200",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871025312",
"telephone_number": "855-832-6727",
"fax_number": "772-675-9100"
}
],
"practiceLocations": [
{
"address_1": "2928 Jefferson St Ste 100",
"address_purpose": "LOCATION",
"city": "Carlsbad",
"state": "CA",
"postal_code": "920082374",
"country_code": "US",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "725 S Mesa Hills Dr Bldg 3",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799125568",
"country_code": "US",
"telephone_number": "855-223-7123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONZALES",
"first_name": "MARISSALYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-19",
"last_updated": "2020-10-21",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-17-29099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.