Individual provider Active NPI

Gina Angel Pollack, LCSW

  • Clinical Social Worker
  • La Mesa, CA
National Provider Identifier
1235654930
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107511 Issued in CA
Practice address
8851 Center Dr Ste 312
La Mesa, CA 91942-3050
Phone
(619) 515-2383
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 107511 CA Primary

Addresses

Primary practice location

8851 Center Dr Ste 312
La Mesa, CA 91942-3050

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other names 1

  • Gina Pollack-Moxley Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20250306002714 CA Practitioner - Clinical Social Worker 8921529942 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107511CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Dec 21, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jan 26, 2026 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Jan 26, 2026 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Community Research Foundation Inc CurrentSince Feb 4, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 21, 2024 Accepting new patients

Locations

8851 Center Dr
Ste 312
La Mesa, CA 91942
Phone (619) 515-2383

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

995 Gateway Center Way
Ste 300
San Diego, CA 92102
Phone (619) 398-2168

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 7

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": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1235654930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR STE 312",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423050",
            "telephone_number": "619-515-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "GINA",
        "middle_name": "ANGEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "POLLACK-MOXLEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.