Individual provider Active NPI

Ignacio Garcia Glucklich

  • Clinical Social Worker
  • Pasadena, CA
National Provider Identifier
1063066439
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104088 Issued in CA
Practice address
2750 E Washington Blvd Ste 230
Pasadena, CA 91107-1449
Phone
(626) 296-8900
NPI assigned
Jul 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 104088 CA
School Social Worker 1041S0200X 104088 CA
Clinical Social Worker 1041C0700X 104088 CA Primary

Addresses

Primary practice location

2750 E Washington Blvd Ste 230
Pasadena, CA 91107-1449

Mailing address

1600 Westerly Ter
Los Angeles, CA 90026-1234
Phone (323) 578-8018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104088CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1063066439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WESTERLY TER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261234",
            "telephone_number": "323-578-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 E WASHINGTON BLVD STE 230",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911071449",
            "telephone_number": "626-296-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA GLUCKLICH",
        "first_name": "IGNACIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "104088",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CA",
            "license": "104088",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.