Jacqueline Gonzalez, AMFT 113958

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

113958 Issued in CA

Practice address

9570 Center Ave Ste 110
Rancho Cucamonga, CA 91730-5842

Phone

(909) 980-2789

Fax

(909) 980-2689

NPI assigned

Oct 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1821323379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9570 CENTER AVE STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305842",
            "telephone_number": "909-980-2789",
            "fax_number": "909-980-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9570 CENTER AVE STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305842",
            "telephone_number": "909-980-2789",
            "fax_number": "909-980-2689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Via Lata Ste 300",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923243978",
            "country_code": "US",
            "telephone_number": "909-433-0445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "AMFT 113958",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RS3295",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacqueline.gonzalez@mhsinc.org",
            "affiliation": "N",
            "endpointDescription": "jacqueline.gonzalez@mhsinc.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9570 Center Ave Ste 110",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917305842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edna Violeta Gonzalez
• Elisa Lepe Gonzalez
• Elizabeth Gonzalez
• Emilia Gonzalez
• Gabrielle Rose Gonzalez, MASTERS
• Jalisa Annelis Gonzalez
• Jesse Josiah Gonzalez
• Kayley Gonzalez
• Liliana Gonzalez, PT, DPT
• Liza M Gonzalez, D.O.

• Marriage & Family Therapist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.