Active NPI
Andrea Gonzalez, LCSW
- Clinical Social Worker
- Imperial Beach, CA
National Provider Identifier
1326346198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 97593
- Practice address
- 742 10TH St
Imperial Beach, CA 91932-2216 - Phone
- (619) 906-5322
- NPI assigned
- Mar 3, 2011
- Last updated
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 97593 | CA | Primary |
Addresses
Primary practice location
742 10TH St
Imperial Beach, CA 91932-2216
Mailing address
PO Box 2152
Imperial Beach, CA 91933-2152
Phone (619) 841-9499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97593 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1326346198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2152",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "919332152",
"telephone_number": "619-841-9499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 10TH ST",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "919322216",
"telephone_number": "619-906-5322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ANDREA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-03",
"last_updated": "2023-01-18",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "97593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Imperial Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.