Active NPI
Michelle Mary Gonzalez Polanco
- Clinical Social Worker
- Stockton, CA
National Provider Identifier
1851878144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 136719
- Practice address
- 1212 N California St
Stockton, CA 95202-1552 - Phone
- (209) 468-8686
- Fax
- (209) 468-2380
- NPI assigned
- Jul 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 136719 | CA | Primary |
| Day Training/Habilitation Specialist | 373H00000X |
Addresses
Primary practice location
1212 N California St
Stockton, CA 95202-1552
Mailing address
1212 N California St
Stockton, CA 95202-1552
Phone (209) 468-8686
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1851878144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021552",
"telephone_number": "209-468-8686",
"fax_number": "209-468-2380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952021552",
"telephone_number": "209-468-8686",
"fax_number": "209-468-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ POLANCO",
"first_name": "MICHELLE",
"middle_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-19",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "136719",
"primary": true
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.