Individual provider Active NPI

Vera Meyerkova Gisis, LCSW

  • Clinical Social Worker
  • Van Nuys, CA
National Provider Identifier
1356466692
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS25631 Issued in CA
Practice address
15339 Saticoy St
Van Nuys, CA 91406-3345
Phone
(818) 267-2748
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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 LCS25631 CA Primary

Addresses

Primary practice location

15339 Saticoy St
Van Nuys, CA 91406-3345

Mailing address

15339 Saticoy St
Van Nuys, CA 91406-3345
Phone (818) 267-2600

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
I20200325000496 CA Practitioner - Clinical Social Worker 8123456142 Practice locations: Encino, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS25631CAMDClinical Social Worker
25631CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1356466692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15339 SATICOY ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063345",
            "telephone_number": "818-267-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15339 SATICOY ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063345",
            "telephone_number": "818-267-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISIS",
        "first_name": "VERA",
        "middle_name": "MEYERKOVA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS25631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.