MR. MARTIN GONZALES (NPI# 1477627495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477627495 |
| Entity Type | Individual |
| Full Name | MR. MARTIN GONZALES |
| Other Name | MRS. VICKIE GONZALES |
| Practice Address |
3924 W Maricopa St Phoenix AZ 85009-5410 |
| Practice Telephone | 6023539352 |
| Mailing Telephone | 6023539352 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
8896 | AZ | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID NUMBER | 910035 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750937876 | Martin Gonzales | Behavior Technician | 1817 Wellspring Ave Se, Rio Rancho, NM 87124-4956 | 2019-08-14 |
| 1942664859 | Martin B. Gonzales | Psychiatry & Neurology | Msc 09 5030, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2016-04-06 |
| Street Address |
3924 W MARICOPA ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85009-5410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578198 | Victoria Gonzales | Respite Care | 3924 W Maricopa St, Phoenix, AZ 85009-5410 | 2020-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220065 | Ashley Medeiros | Specialist/Technologist | 2926 E. Encanto Blvd., Phoenix, AZ 85009 | 2020-09-16 |
| 1326252909 | Raul Herreras | Speech-Language Pathologist | 3101 W. Mcdowell Road, Phoenix, AZ 85009 | 2007-05-10 |
| 1295956779 | Gerardo Gaerlan Gregorio | Internal Medicine | 3250 W. Lower Buckeye Road, Phoenix, AZ 85009 | 2007-05-01 |
| 1316060338 | Eve Ronnie Davidson | Registered Nurse | 3333wroosevelt, Phoenix, AZ 85009 | 2007-04-06 |
| 1679693808 | Paul Thomas Lorentsen | Internal Medicine | 1929 W. Fillmore St, Bldg C, The Neighborhood Christian Clinic, Phoenix, AZ 85009 | 2007-03-30 |
| 1134246655 | Audrea J Chambers-pryce | Registered Nurse | 3715 W Roosevelt, Phx, AZ 85009 | 2007-03-22 |
| 1053437582 | Monique Marie Knepper | Licensed Practical Nurse | 3025 W Mc Dowell Rd, Phoenix, AZ 85009 | 2007-03-22 |
| 1245356054 | Lena Rose Felder | Speech-Language Pathologist | 3348 W. Mcdowell Rd., Phoenix, AZ 85009 | 2007-03-22 |
| 1508900036 | Walter M Wood | Psychologist | 3348 W Mcdowell Road, Phoenix, AZ 85009 | 2007-02-17 |
| 1194869982 | Maureen Brukardt | Registered Nurse | 3449 N 39th Ave, Phx, AZ 85009 | 2007-02-16 |
| Find all providers in zip 85009 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
| 1912552381 | Leslie E Alfieri | Respite Care | 2250 E Deer Valley Rd Unit 48, Phoenix, AZ 85024-5530 | 2019-08-02 |
| 1811404437 | Montique S Collins | Respite Care | 729 W Maldonado Rd, Phoenix, AZ 85041-6763 | 2018-01-04 |
| 1801341441 | Asha Dey | Respite Care | 1914 W Carson Rd, Phoenix, AZ 85041-6658 | 2016-08-24 |
| 1811352016 | Megan Pirehpour | Respite Care | 25622 N Singbush Loop, Phoenix, AZ 85083-2457 | 2015-12-15 |
| 1093109050 | Ligia Ahumada | Respite Care | 7111 W Pioneer St, Phoenix, AZ 85043-7209 | 2015-03-26 |
| 1871914119 | Debbie Okojie | Respite Care | 4041 N 27th St Unit 110, Phoenix, AZ 85016-6773 | 2014-01-03 |
| 1578993895 | Ronald Harris | Respite Care | 2512 W Saint Catherine Ave, Phoenix, AZ 85041-5354 | 2013-11-22 |
| 1235569849 | Terry Jackson | Respite Care | 6605 S 18th Dr, Phoenix, AZ 85041-5841 | 2013-11-18 |
| 1245579895 | Annette Keil | Respite Care | 3901 E Emile Zola Ave, Phoenix, AZ 85032-6225 | 2013-02-01 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.