Individual provider Active NPI

Gina Vonlossberg, LCSW #97464

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1063786788
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
97464 Issued in CA
Practice address
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone
(310) 221-6336
NPI assigned
Feb 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW59873 CA
Clinical Social Worker 1041C0700X 97464 CA Primary

Addresses

Primary practice location

1501 Hughes Way Ste 150
Long Beach, CA 90810-1878

Mailing address

1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 221-6336

Other practice location 1

1529 E Palmdale Blvd
Palmdale, CA 93550-2034
Phone (661) 208-4242

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
ASW59873CAMDMental Health Counselor
97464CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1063786788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101878",
            "telephone_number": "310-221-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101878",
            "telephone_number": "310-221-6336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1529 E Palmdale Blvd",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935502034",
            "country_code": "US",
            "telephone_number": "661-208-4242",
            "fax_number": "661-224-2187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VONLOSSBERG",
        "first_name": "GINA",
        "credential": "LCSW #97464",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW59873",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.