Active NPI
Gary C Wenk, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1255438909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS 16578
- Practice address
- 1094 Cudahy PL
Suite 314
San Diego, CA 92110-3931 - Phone
- (619) 341-9297
- NPI assigned
- Sep 17, 2006
- 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 | LCS 16578 | CA | Primary |
Addresses
Primary practice location
1094 Cudahy PL
Suite 314
San Diego, CA 92110-3931
Mailing address
1094 Cudahy PL
Suite 314
San Diego, CA 92110-3931
Phone (619) 341-9297
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 16578 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299888000000",
"number": "1255438909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1094 CUDAHY PL",
"address_2": "SUITE 314",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103931",
"telephone_number": "619-341-9297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1094 CUDAHY PL",
"address_2": "SUITE 314",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103931",
"telephone_number": "619-341-9297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENK",
"first_name": "GARY",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2011-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS 16578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.