Johnny Dean Gonzales, BS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

103TA0400X Issued in OR

Practice address

10180 SE Sunnyside Rd
1St Floor, Wing a
Clackamas, OR 97015-8970

Phone

(503) 571-0884

Fax

(503) 571-0866

NPI assigned

Mar 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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.

• Brookside Center

  • Special Hospital
  • Clackamas, OR
  • NPI 1316203508
  NPD (past) Authorized official
• Kaiser Permanente

  • General Acute Care Hospital
  • Clackamas, OR
  • NPI 1326282880
  NPD (past)

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1871868976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "address_2": "1ST FLOOR, WING A",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-571-0884",
            "fax_number": "503-571-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "address_2": "1ST FLOOR, WING A",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-571-0884",
            "fax_number": "503-571-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JOHNNY",
        "middle_name": "DEAN",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "103TA0400X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Michelle Goka, PA-C
• Seth Harrison Goldberg, MS, CRNA
• Joshua Starbuck Virgen Goldner, M.D.
• Seth Leopold Goldsmith, M.D.
• Zoe Gombart, MD
• Justin D Gonzales, DMD
• Peter E Goodkin, MD
• Trudy Goodloe
• Justin Ryan Goodman, DDS
• Renee Nicole Goodreau, M.D.

• Addiction (Substance Use Disorder) Counselor in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.