Individual provider Active NPI

Kristyn P Gonzaga, NP

  • Primary Care Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1750170411
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95032936 Issued in CA
Practice address
3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061
Phone
(888) 789-9585
Fax
(562) 803-4500
NPI assigned
Apr 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95032936 CA Primary

Addresses

Primary practice location

3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061

Mailing address

3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061
Phone (888) 789-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728002738 CA Practitioner - Nurse Practitioner 1153838834 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
GN Medical Associates, IncGroup PAC ID 5092605816, 40 clinicians
Careconnectmd Ca PCGroup PAC ID 5496178055, 30 clinicians
Innovative Wound Solutions IncGroup PAC ID 0446758858, 26 clinicians

Practice addresses (Care Compare)

3090 Bristol St
Suite 200
Costa Mesa, CA 92626-3061
Phone (888) 789-9585

44045 Margarita Rd
Suite 101
Temecula, CA 92592-2729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032936CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Ca PC CurrentSince Feb 2, 2026 Accepting new patients
Innovative Wound Solutions Inc CurrentSince Oct 13, 2025 Accepting new patients
Care Partners California Medical PC CurrentSince Feb 2, 2026 Accepting new patients
Wound Guard Inc CurrentSince Dec 1, 2025 Accepting new patients
Woundguard CurrentSince Dec 1, 2025 Accepting new patients
GN Medical Associates, Inc. CurrentSince Feb 2, 2026 Accepting new patients

Locations

495 E Rincon St
Ste 105
Corona, CA 92879
Phone (888) 969-9808

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

1750 Montgomery St
Fl 1
San Francisco, CA 94111
Phone (714) 619-8777

3401 W Sunflower Ave
#250
Santa Ana, CA 92704
Phone (415) 848-8258

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

44045 Margarita Rd
Ste 101
Temecula, CA 92592
Phone (951) 302-1122

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1750170411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061",
            "telephone_number": "888-789-9585",
            "fax_number": "562-803-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061",
            "telephone_number": "888-789-9585",
            "fax_number": "562-803-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZAGA",
        "first_name": "KRISTYN",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-30",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95032936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.