Active NPI
Jessica Gonzalez Padilla, LPC
- Professional Counselor
- Boerne, TX
National Provider Identifier
1811132004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63035
- Practice address
- 121 Old San Antonio Rd
Boerne, TX 78006-3415 - Phone
- (830) 816-2425
- Fax
- (830) 249-8714
- NPI assigned
- Dec 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63035 | TX | Primary |
Addresses
Primary practice location
121 Old San Antonio Rd
Boerne, TX 78006-3415
Mailing address
3103 West Ave
San Antonio, TX 78213-4535
Phone (210) 340-8077
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
| License | State | Type | Specialty |
|---|---|---|---|
| 63035 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roy Maas' Youth Alternatives, Inc. | Professional | Past | 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": "1228262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1811132004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 WEST AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782134535",
"telephone_number": "210-340-8077",
"fax_number": "210-340-2232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 OLD SAN ANTONIO RD",
"city": "BOERNE",
"state": "TX",
"postal_code": "780063415",
"telephone_number": "830-816-2425",
"fax_number": "830-249-8714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADILLA",
"first_name": "JESSICA",
"middle_name": "GONZALEZ",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-03",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.