Individual provider Active NPI

Rosa Delia Carmona Gomez, LCSW

  • Mental Health Counselor
  • Merced, CA
National Provider Identifier
1013426774
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
480 E 13TH St
Merced, CA 95341-6214
Phone
(209) 381-6800
NPI assigned
Sep 26, 2017
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

480 E 13TH St
Merced, CA 95341-6214

Mailing address

PO Box 2087
Merced, CA 95344-0087
Phone (209) 381-6800

Other names 1

  • Ms. Rosa Carmona Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215001573 CA Practitioner - Clinical Social Worker 6305280587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107428CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lumira Healthcare Current Accepting new patients
Lumira Healthcare PastSince Aug 1, 2020 Accepting new patients

Locations

2412 3rd St
Hughson, CA 95326
Phone (209) 558-7250

1140 Main St
Livingston, CA 95334
Phone (209) 394-7913

600 B St
Ste B
Livingston, CA 95334
Phone (209) 850-3500

2116 E Orangeburg Ave
Modesto, CA 95355
Phone (209) 529-1709

800 Delbon Ave
Turlock, CA 95382
Phone (209) 664-8000

12619 Bentley St
Waterford, CA 95386
Phone (209) 442-6200

Interoperability endpoints

  • Direct secure messaging: rosa.carmonalcsw.p3@direct.livingstoncommunity.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1013426774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953440087",
            "telephone_number": "209-381-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 E 13TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416214",
            "telephone_number": "209-381-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMONA GOMEZ",
        "first_name": "ROSA",
        "middle_name": "DELIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "CARMONA",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.