Active NPI
Paolo Romano Salonga Gargantiel
- Clinical Social Worker
- Martinez, CA
National Provider Identifier
1174650089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 23509
- Practice address
- 1340 Arnold Dr Ste 200
Martinez, CA 94553-4189 - Phone
- (925) 655-2404
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCS 23509 | CA | |
| Clinical Social Worker | 1041C0700X | 23509 | CA | Primary |
Addresses
Primary practice location
1340 Arnold Dr Ste 200
Martinez, CA 94553-4189
Mailing address
1340 Arnold Dr Ste 200
Martinez, CA 94553-4189
Phone (925) 655-2404
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 |
|---|---|---|---|
| LCS 23509 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1174650089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 ARNOLD DR STE 200",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534189",
"telephone_number": "925-655-2404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 ARNOLD DR STE 200",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534189",
"telephone_number": "925-655-2404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARGANTIEL",
"first_name": "PAOLO",
"middle_name": "ROMANO SALONGA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LCS 23509",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "23509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.