Individual provider Active NPI

Brianna Gonzalez

  • Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1841801339
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3806 Waterfall Canyon Dr
Bakersfield, CA 93313-5516
Phone
(661) 617-0234
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3806 Waterfall Canyon Dr
Bakersfield, CA 93313-5516

Mailing address

3806 Waterfall Canyon Dr
Bakersfield, CA 93313-5516
Phone (661) 617-0234

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bgonzalez1470334@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20210121001169 OR Practitioner - Physician Assistant 6002220779 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

1500 Division St
Oregon City, OR 97045-1527
Phone (503) 557-2136

1510 Division St
Oregon City, OR 97045-1599

Hospital & facility affiliations

  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Mar 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 1, 2021 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 1, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 1, 2021 Accepting new patients

Locations

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

1510 Division St
Ste 210
Oregon City, OR 97045
Phone (503) 655-6313

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Interoperability endpoints

  • Direct secure messaging: bgonzalez1470334@oc.providencedirect.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1841801339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 WATERFALL CANYON DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933135516",
            "telephone_number": "661-617-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 WATERFALL CANYON DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933135516",
            "telephone_number": "661-617-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgonzalez1470334@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1510 Division St Ste 210",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.