JORDAN ANTHONY GONZALES LMFT, ATR-P
NPI 1174017677
Marriage & Family Therapist in Redwood City, CA

Q: What is Jordan Gonzales's NPI number?

The NPI number for Jordan Gonzales is 1174017677. It was assigned to this individual provider in the NPPES registry on June 18, 2018.

Q: What is Jordan Gonzales's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Jordan Gonzales enrolled in Medicare?

No. Jordan Gonzales has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jordan Gonzales was last updated on March 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 18, 2018Opted out of Medicare · through Jan 1, 2028

400 EDMONDS RD, REDWOOD CITY, CA 94062(650) 839-1810 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2021, Jun 18, 2018 (2 updates tracked since 2018).

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About Jordan Anthony Gonzales Lmft, Atr-p NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN ANTHONY GONZALES LMFT, ATR-P (NPI 1174017677) is an individual marriage & family therapist in Redwood City, California and active in the NPI registry since June 2018. He has opted out of Medicare through January 1, 2028 and maintains a secondary practice location in San Mateo.

NPPES Registry Identity

NPI1174017677

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameJORDAN ANTHONY GONZALESCredential: LMFT, ATR-P

Location Address400 EDMONDS RDRedwood City, CA 94062-3803

Mailing Address20353 Park Way Apt 44Castro Valley, CA 94546-5324 · (916) 215-8068

Phone(650) 839-1810

Sole ProprietorNo

Enumeration DateJune 18, 2018

Last NPPES UpdateMarch 17, 20212 updates tracked since enumeration

NPPES CertifiedMarch 17, 2021

✔ NPI 1174017677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

400 EDMONDS RD, Redwood City, CA 94062

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Secondary Practice Location 1

Location 1225 37th Ave Fl 3San Mateo, CA 94403-4324 · Phone (650) 363-4000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jordan Anthony Gonzales Lmft, Atr-p has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. REMBERTO CALERO JR.

Counselor (Mental Health)