Active NPI
Gabriel Lee Leon, LCSW
- Clinical Social Worker
- Norco, CA
National Provider Identifier
1174876304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 79187
- Practice address
- 5TH Street & Western
Norco, CA 92860-0991 - Phone
- (951) 737-2683
- NPI assigned
- Oct 25, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 60774 | CA | |
| School Social Worker | 1041S0200X | 79187 | CA | |
| Clinical Social Worker | 1041C0700X | 79187 | CA | Primary |
Addresses
Primary practice location
5TH Street & Western
Norco, CA 92860-0991
Mailing address
5105 Peacock LN
Riverside, CA 92505-3101
Phone (805) 907-8779
Other practice location 1
611 W Civic Center Dr Ste 209
Santa Ana, CA 92701-4021
Phone (909) 952-2860
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 |
|---|---|---|---|
| 79187 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novo Behavioral Services | Clinical | Current | Accepting new patients |
Locations
611 W Civic Center Dr
Ste 209
Santa Ana, CA 92701
Phone (714) 257-5534
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705017600000",
"number": "1174876304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 PEACOCK LN",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925053101",
"telephone_number": "805-907-8779",
"fax_number": "909-259-2897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5TH STREET & WESTERN",
"city": "NORCO",
"state": "CA",
"postal_code": "928600991",
"telephone_number": "951-737-2683"
}
],
"practiceLocations": [
{
"address_1": "611 W Civic Center Dr Ste 209",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927014021",
"country_code": "US",
"telephone_number": "909-952-2860",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEON",
"first_name": "GABRIEL",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-25",
"last_updated": "2024-01-12",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "60774",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "CA",
"license": "79187",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "79187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.