Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TAMARA ELISSE GONZALEZ
NPI 1255011367
Marriage & Family Therapist in Colton, CA

Q: What is Tamara Gonzalez's NPI number?

The NPI number for Tamara Gonzalez is 1255011367. It was assigned to this individual provider in the NPPES registry on July 24, 2023.

Q: What is Tamara Gonzalez's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Tamara Gonzalez was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 24, 2023PECOS Enrolled

1330 E COOLEY DR, COLTON, CA 92324(909) 580-3705 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 25, 2026, Aug 3, 2026, Feb 2, 2026 and 1 more (4 updates tracked since 2023).

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About Tamara Elisse Gonzalez NPPES

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

TAMARA ELISSE GONZALEZ (NPI 1255011367) is an individual marriage & family therapist in Colton, California, licensed in California (136056) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Alta Loma, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1255011367

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameTAMARA ELISSE GONZALEZ

Location Address1330 E COOLEY DRColton, CA 92324-3905

Mailing AddressPo Box 1261Upland, CA 91785-1261 · (909) 732-5936

Phone(909) 580-3705

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateJuly 24, 2023

Last NPPES UpdateAugust 25, 20264 updates tracked since enumeration

NPPES CertifiedAugust 25, 2026

✔ NPI 1255011367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 136056

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.

1330 E COOLEY DR, Colton, CA 92324

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Secondary Practice Location 1

Location 18326 Banyan StAlta Loma, CA 91701-2602 · Phone (909) 732-5936

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tamara Elisse Gonzalez is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID244728491

PECOS Enrollment IDI20251021001917

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

MS. JUDITH A TATE LSW

Counselor