Individual provider Active NPI

Stephanie Layne Gonzalez, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1790433860
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1073426 Issued in TX
Practice address
5373 W Alabama St
Houston, TX 77056-5930
Phone
(888) 279-0002
NPI assigned
Mar 16, 2022
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61437110 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026430 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10845 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1073426 TX Primary

Addresses

Primary practice location

5373 W Alabama St
Houston, TX 77056-5930

Mailing address

202 S. Lamar St.
Weatherford, TX 76086
Phone (888) 279-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240911001774 TX Practitioner - Nurse Practitioner 7416497912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

Austin, TX 78731
Phone (415) 360-3348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209026430ILMDPsychiatric/Mental Health Nurse Practitioner
10845MNMDPsychiatric/Mental Health Nurse Practitioner
AP61437110WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Aug 1, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737

Interoperability endpoints

  • Direct secure messaging: stephanie.gonzalez.1@22469.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1790433860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S. LAMAR ST.",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "76086",
            "telephone_number": "888-279-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 W ALABAMA ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770565930",
            "telephone_number": "888-279-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "STEPHANIE",
        "middle_name": "LAYNE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61437110",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209026430",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "10845",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1073426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.