Active NPI
Tonja M Gaudette, CIS
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1326367673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS68947
- Practice address
- 6060 Paramount Blvd
Long Beach, CA 90805 - Phone
- (562) 634-9534
- Fax
- (562) 790-1867
- NPI assigned
- May 26, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Clinical Social Worker | 1041C0700X | LCS68947 | CA | Primary |
Addresses
Primary practice location
6060 Paramount Blvd
Long Beach, CA 90805
Mailing address
36 La Mirage Cir
Aliso Viejo, CA 92656
Phone (714) 296-3403
Other names 1
- Tonja Becwar
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS68947 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1326367673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 LA MIRAGE CIR",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "92656",
"telephone_number": "714-296-3403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6060 PARAMOUNT BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90805",
"telephone_number": "562-634-9534",
"fax_number": "562-790-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDETTE",
"first_name": "TONJA",
"middle_name": "M",
"credential": "CIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-26",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS68947",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "441 N Lakeview Ave",
"city": "Anaheim",
"state": "CA",
"country_code": "US",
"postal_code": "928073028",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "TONJA",
"last_name": "BECWAR",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.