Individual provider Active NPI

Veronica Briana Gardner-Mendoza, LCSW

  • Social Worker
  • Burbank, CA
National Provider Identifier
1235376450
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
305 E Valencia Ave Apt R
Burbank, CA 91502-2657
Phone
(818) 470-8302
NPI assigned
Jan 9, 2009
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

305 E Valencia Ave Apt R
Burbank, CA 91502-2657

Mailing address

305 E Valencia Ave Apt R
Burbank, CA 91502-2657
Phone (818) 470-8302

Other practice location 1

2626 Foothill Blvd Ste 208
LA Crescenta, CA 91214-3574
Phone (818) 470-8302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171002002230 CA Practitioner - Clinical Social Worker 6103191150 Reassigns benefits to 1 organization
Practice locations: Burbank, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Burbank, CA 91502
Phone (818) 470-8302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28067CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Headway California Behavioral Health Services, P.C. CurrentSince Sep 25, 2023 Accepting new patients
Teladoc Health Medical Group, P.a. Current Accepting new patients
Darrell Broaddus Psychological Services PC Past Accepting new patients

Locations

680 E Colorado Blvd
Ste 180
Pasadena, CA 91101
Phone (213) 557-2286

114 5th Ave
Fl 2
New York, NY 10011
Phone (347) 569-3733

Interoperability endpoints

  • Direct secure messaging: veronicagardnermendoza@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1235376450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E VALENCIA AVE APT R",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022657",
            "telephone_number": "818-470-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E VALENCIA AVE APT R",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915022657",
            "telephone_number": "818-470-8302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2626 Foothill Blvd Ste 208",
            "address_purpose": "LOCATION",
            "city": "LA Crescenta",
            "state": "CA",
            "postal_code": "912143574",
            "country_code": "US",
            "telephone_number": "818-470-8302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER-MENDOZA",
        "first_name": "VERONICA",
        "middle_name": "BRIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.