Graciela Gonzalez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS-28975 Issued in CA

Practice address

9931 Haddon Ave
Pacoima, CA 91331-3305

Phone

(261) 281-8426

NPI assigned

Aug 10, 2007

Last updated

Jul 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Graciela Baltazar Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Northeast Valley Health Corporation

  dba Van Nuys Adult Health Center

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1629079009
  Medicare reassignment NPD
• Robert P Kahn-Rose, Inc.

  • Specialist
  • Agoura Hills, CA
  • NPI 1407936784
  Medicare reassignment NPD
• Path T0 Mindful Balanced Mental Wellness, Inc

  • Adult Mental Health Clinic/Center
  • Granada Hills, CA
  • NPI 1720979214
  NPD Authorized official
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Sun Valley, CA
  • NPI 1013199264
  NPD
• Northeast Valley Health Corporation

  dba SCV Dental and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Santa Clarita, CA
  • NPI 1548960834
  NPD

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1316139611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9945 COLUMBUS AVE",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913453046",
            "telephone_number": "818-898-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9931 HADDON AVE",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913313305",
            "telephone_number": "261-281-8426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6551 Van Nuys Blvd # 201",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914011442",
            "country_code": "US",
            "telephone_number": "818-988-9578",
            "fax_number": "818-702-9578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GRACIELA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS-28975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACIELA",
            "last_name": "BALTAZAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Denise Gonzales
• Jose Manuel Gonzalez-Diaz, MD
• Bernice Gonzalez
• Brandon Gonzalez
• Claudia Janet Gonzalez, BA
• Katherine Gonzalez
• Leonardo Gonzalez
• Lizette Gonzalez
• Martha Elizabeth Gonzalez, BA
• Hilary Gordon

• Clinical Social Worker in Pacoima, CA
• Providers in Pacoima, 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 Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.