Active NPI
Clarisa Gonzalez, LND
- Nutrition Education Nutritionist
- San Juan, PR
National Provider Identifier
1972853745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- License
- 1241
- Practice address
- Urb Montehiedra
165 Calle Pitirre
San Juan, PR 00926-7103 - Phone
- (787) 210-6995
- Fax
- (305) 675-7910
- NPI assigned
- Sep 19, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 1241 | PR | Primary |
Addresses
Primary practice location
Urb Montehiedra
165 Calle Pitirre
San Juan, PR 00926-7103
Mailing address
30 Padial St.
Gatsby Plaza Suite 212
Caguas, PR 00725
Phone (787) 210-6995
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1241 | PR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1972853745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 PADIAL ST.",
"address_2": "GATSBY PLAZA SUITE 212",
"city": "CAGUAS",
"state": "PR",
"postal_code": "00725",
"telephone_number": "787-210-6995",
"fax_number": "787-653-7555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB MONTEHIEDRA",
"address_2": "165 CALLE PITIRRE",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009267103",
"telephone_number": "787-210-6995",
"fax_number": "305-675-7910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "CLARISA",
"name_prefix": "Mrs.",
"credential": "LND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2024-07-12",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "PR",
"license": "1241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.