Gloria Gonzalez Campise, L.M. (LICENCED MIDWI

Primary specialty

MidwifeTaxonomy code 176B00000X

License

LM612 Issued in CA

Practice address

205 W. Clay Street
Ukiah, CA 95482

Phone

(707) 621-5012

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Gloria Enriqueta Gonzalez Former name

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1932726726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 553",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-391-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W. CLAY STREET",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-621-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPISE",
        "first_name": "GLORIA",
        "middle_name": "GONZALEZ",
        "name_prefix": "Ms.",
        "credential": "L.M. (LICENCED MIDWI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "GONZALEZ",
            "middle_name": "ENRIQUETA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tom Buske
• Linda Rene Butler, MFT
• Erik Stephen Cabral, M.D.
• Jason A Cabral
• Joseph Scott Campbell
• Tami Canovas
• Christoffer Cansicio
• Rachel Raymundo Capistrano, RN
• Valerie J Capri
• Leartis Caradine

• Midwife in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.