Individual provider Active NPI

Tonantzin Mevelia Gonzalez

  • Clinical Social Worker
  • Perris, CA
National Provider Identifier
1790334126
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115175 Issued in CA
Practice address
975 Morgan St
Perris, CA 92571-3103
Phone
(951) 940-6100
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23-7110152 CA
Clinical Social Worker 1041C0700X 115175 CA Primary

Addresses

Primary practice location

975 Morgan St
Perris, CA 92571-3103

Mailing address

701 Van Way
Perris, CA 92570-3418

Other practice location 1

12321 Magnolia Ave
Riverside, CA 92503-4736
Phone (714) 681-0052

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
23-7110152CAMDAddiction (Substance Use Disorder) Counselor
115175CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Val Verde Unified School District PastSince Sep 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1790334126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 VAN WAY",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925703418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 MORGAN ST",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925713103",
            "telephone_number": "951-940-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12321 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925034736",
            "country_code": "US",
            "telephone_number": "714-681-0052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "TONANTZIN",
        "middle_name": "MEVELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "23-7110152",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.