Jared Gonzales

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY1734 Issued in NM

Practice address

1395 Missouri Ave
Las Cruces, NM 88001-5327

Phone

(575) 621-4304

NPI assigned

Oct 18, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jared J. Gonzales LLCGroup PAC ID 6709254386, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Jared J. Gonzales LLC

  • Psychologist
  • Las Cruces, NM
  • NPI 1245963651
  Medicare reassignment Care Compare group NPD Authorized official
• Las Cruces School District No. 2

  • Local Education Agency (LEA)
  • Las Cruces, NM
  • NPI 1851301857
  NPD (past)

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1801224332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4672 MESITA ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880126329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 MISSOURI AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015327",
            "telephone_number": "575-621-4304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St Ste 249",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011243",
            "country_code": "US",
            "telephone_number": "575-527-5884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-18",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NM",
            "license": "313091",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY1734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cebrina J Gonzales
• Christina Gonzales, RBT
• Felix Olmedo Gonzales Jr., ORDAINED PASTOR
• Gregory Lee Gonzales, M.S., LPCC
• Isabel Gonzales, LCSW
• Julia Gonzales, M.A., CF-SLP
• Krista J Gonzales, M.A. CF-SLP
• Laura N Gonzales, BCBA
• Malerie Gonzales
• Maria Diana Gonzales

• Clinical Psychologist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.