Individual provider Active NPI

Mabelle Erica Gozun McKahan, LCSW

  • Clinical Social Worker
  • San Marcos, CA
National Provider Identifier
1255993127
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112851 Issued in CA
Practice address
1595 Grand Ave Ste 100
San Marcos, CA 92078-2450
Phone
(760) 736-6767
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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 112851 CA Primary

Addresses

Primary practice location

1595 Grand Ave Ste 100
San Marcos, CA 92078-2450

Mailing address

150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6767

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
I20230912001576 CA Practitioner - Clinical Social Worker 6002270956 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
92611CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Didi Hirsch Psychiatric Service CurrentSince Jul 29, 2023 Accepting new patients
Gardner Family Health Network Inc CurrentSince Aug 6, 2024 Accepting new patients
Didi Hirsch Psychiatric Service Current Accepting new patients
Didi Hirsch Psychiatric Service CurrentSince Jul 29, 2023 Accepting new patients
Gardner Family Health Network, Inc. CurrentSince Aug 6, 2024 Accepting new patients

Locations

4760 Sepulveda Blvd
Los Angeles, CA 90230
Phone (310) 751-5344

160 E Virginia St
San Jose, CA 95112
Phone (408) 579-6178

160 E Virginia St
Ste 100
San Jose, CA 95112
Phone (408) 918-2618

Organizations & group practices 5

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1255993127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 GRAND AVE STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782450",
            "telephone_number": "760-736-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAHAN",
        "first_name": "MABELLE",
        "middle_name": "ERICA GOZUN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "112851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.