Jerry Andrew Gorman, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW93390 Issued in CA

Practice address

275 Beck Ave # Ms 5-250
Fairfield, CA 94533-6804

Phone

(707) 784-8355

Fax

(707) 784-8355

NPI assigned

Oct 9, 2018

Last updated

Jan 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1023583721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BECK AVE # MS 5-250",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336804",
            "telephone_number": "707-784-8355",
            "fax_number": "707-784-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BECK AVE # MS 5-250",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336804",
            "telephone_number": "707-784-8355",
            "fax_number": "707-784-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "JERRY",
        "middle_name": "ANDREW",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW93390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rowena Escuna Gonzalez
• Yaridxi Gonzalez
• Venus Sherrill Goodwin, NONE
• Kimberly Allison Gordon, PHARM.D.
• Lora Lynne Gordon, CADC II
• Haley Dawn Gosvener
• Steven T. Gotanda, MD
• Sharon G Goudeau-Goodall
• Fredric Gough, MD
• Heather Robyn Gough, MSW, JD

• Clinical Social Worker in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.