Stephanie R Gaxiola, MSW, LCSW, LICSW, MP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114657 Issued in MA

Practice address

16710 Ventura Blvd
#403
Encino, CA 91436-1713

Phone

(415) 694-8465

NPI assigned

Dec 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1295004091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16710 VENTURA BLVD",
            "address_2": "#403",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361713",
            "telephone_number": "415-694-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16710 VENTURA BLVD",
            "address_2": "#403",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361713",
            "telephone_number": "415-694-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAXIOLA",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, LICSW, MP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012192",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichelle Janise Gatewood, MA, ABA,
• Cintia E Gatica Guatemala
• Caitlin Gattuccio
• Muriel Ghislaine Gaudin, MFT
• Vanessa Gavilanez
• Andrea Vicki Geffner
• Sarah Gehrke, PMHNP-BC
• Vadim Geller
• Charlyne M Gelt Price, PHD
• Irene Gendelman, M.A., MFT INTERN.,

• Clinical Social Worker in Encino, CA
• Providers in Encino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.

Verify at the official NPI Registry.