Healthcare Provider Details

I. General information

NPI: 1184543704
Provider Name (Legal Business Name): JG PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 VALLEY WEST DR STE 109
WEST DES MOINES IA
50266-1902
US

IV. Provider business mailing address

1200 VALLEY WEST DR STE 109
WEST DES MOINES IA
50266-1902
US

V. Phone/Fax

Practice location:
  • Phone: 515-207-5101
  • Fax: 515-272-7238
Mailing address:
  • Phone: 515-207-5101
  • Fax: 515-272-7238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JUDY GONZALES
Title or Position: OWNER
Credential: ARNP, PMHNP
Phone: 515-207-5101