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MR. MARTIN GONZALES NPI 1477627495


NPI Information

NPI: 1477627495
Provider Name: MR. MARTIN GONZALES
Classification: Respite Care - 385HR2055X
Entity Type: Individual

Specialization: Respite Care, Mental Illness, Child

Address:
3924 W MARICOPA ST
PHOENIX, AZ
ZIP 85009
Phone: (602) 353-9352
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MR. Martin Gonzales is a respite care and mental illness and child respite care in Phoenix, AZ. The provider is 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. MR. Martin Gonzales NPI is 1477627495. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3924 W MARICOPA ST
PHOENIX, AZ
ZIP 85009-410
Phone: (602) 353-9352

The enumeration date for this NPI number is 11/20/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1385HR2055XRespite CareRespite Care, Mental Illness, Child8896ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1910035OTHERARIZONAAHCCCS ID NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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