Individual provider Active NPI

Gabriella Roxanna Lacayo, B.A.

  • Case Manager/Care Coordinator
  • Pasadena, CA
National Provider Identifier
1366797094
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
D6911856 Issued in CA
Practice address
36 S Kinneloa Ave
Pasadena, CA 91107-3853
Phone
(626) 795-7218
NPI assigned
Jul 18, 2012
Last updated
Jul 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X D6911856 CA Primary

Addresses

Primary practice location

36 S Kinneloa Ave
Pasadena, CA 91107-3853

Mailing address

36 S Kinneloa Ave
Pasadena, CA 91107-3853
Phone (626) 795-7218

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
D6911856CAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1366797094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 S KINNELOA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073853",
            "telephone_number": "626-795-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S KINNELOA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073853",
            "telephone_number": "626-795-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAYO",
        "first_name": "GABRIELLA",
        "middle_name": "ROXANNA",
        "credential": "B.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "D6911856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.