Active NPI
Gina Marie Gregory, LCSW
- Social Worker
- Los Angeles, CA
National Provider Identifier
1356625636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 2240 Venice Blvd # 15a
Los Angeles, CA 90006-5108 - Phone
- (310) 220-0350
- NPI assigned
- Oct 4, 2011
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904011119 | VA | |
| Clinical Social Worker | 1041C0700X | 73689 | CA | |
| Clinical Social Worker | 1041C0700X | 09926035 | CO | |
| Clinical Social Worker | 1041C0700X | 020630 | PA | |
| Clinical Social Worker | 1041C0700X | 68047 | TX | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
2240 Venice Blvd # 15a
Los Angeles, CA 90006-5108
Mailing address
6221 Geary Blvd
San Francisco, CA 94121-1887
Phone (415) 474-7310
Other practice location 1
19 S B St
San Mateo, CA 94401-3994
Phone (310) 220-0350
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68047 | TX | MD | Professional Counselor |
| 09926035 | CO | MD | Clinical Social Worker |
| 020630 | PA | MD | Clinical Social Worker |
| 0904011119 | VA | MD | Clinical Social Worker |
| 73689 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1356625636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6221 GEARY BLVD",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211887",
"telephone_number": "415-474-7310",
"fax_number": "415-751-3226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 VENICE BLVD # 15A",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900065108",
"telephone_number": "310-220-0350"
}
],
"practiceLocations": [
{
"address_1": "19 S B St",
"address_purpose": "LOCATION",
"city": "San Mateo",
"state": "CA",
"postal_code": "944013994",
"country_code": "US",
"telephone_number": "310-220-0350",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREGORY",
"first_name": "GINA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-04",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904011119",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "73689",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "09926035",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "020630",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "68047",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.