Individual provider Active NPI

Gerardo Angel Godinez

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1720806482
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
286 Euclid Ave Ste 207
San Diego, CA 92114-3612
Phone
(619) 859-6270
NPI assigned
Oct 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MPSS-NYPLJW CA
Case Manager/Care Coordinator 171M00000X CA
Student in an Organized Health Care Education/Training Program 390200000X CA Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

286 Euclid Ave Ste 207
San Diego, CA 92114-3612

Mailing address

286 Euclid Ave Ste 207
San Diego, CA 92114-3612
Phone (619) 859-6270

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

State licenses

LicenseStateTypeSpecialty
MPSS-NYPLJWCAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1720806482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143612",
            "telephone_number": "619-859-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 EUCLID AVE STE 207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921143612",
            "telephone_number": "619-859-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODINEZ",
        "first_name": "GERARDO",
        "middle_name": "ANGEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-01",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-NYPLJW",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 10, 2026; 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.