Individual provider Active NPI

Joanna M Gonzalez

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1780467001
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023499 Issued in CA
Practice address
1225 M St
Fresno, CA 93721-1805
Phone
(559) 600-8600
NPI assigned
Aug 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95023499 CA Primary

Addresses

Primary practice location

1225 M St
Fresno, CA 93721-1805

Mailing address

2406 Garvey Ave
Corcoran, CA 93212-1515
Phone (623) 202-3425

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
I20240801003242 CA Order and Referring Only - Nurse Practitioner 5496292997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95023499CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1780467001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 GARVEY AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932121515",
            "telephone_number": "623-202-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 M ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211805",
            "telephone_number": "559-600-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOANNA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.