Active NPI
Eliott Gillooly
- Clinical Social Worker
- Costa Mesa, CA
National Provider Identifier
1144801721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 140350
- Practice address
- 2900 Bristol St Ste E103
Costa Mesa, CA 92626-7906 - Phone
- (714) 814-3336
- NPI assigned
- Apr 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 140350 | CA | Primary |
Addresses
Primary practice location
2900 Bristol St Ste E103
Costa Mesa, CA 92626-7906
Mailing address
PO Box 95
Long Beach, CA 90801-0095
Phone (562) 270-4414
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
| License | State | Type | Specialty |
|---|---|---|---|
| 98291 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785456000000",
"number": "1144801721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 95",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908010095",
"telephone_number": "562-270-4414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 BRISTOL ST STE E103",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926267906",
"telephone_number": "714-814-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLOOLY",
"first_name": "ELIOTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-15",
"last_updated": "2026-07-31",
"certification_date": "2026-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "140350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.