Beda Gamboa, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

61555 Issued in CA

Practice address

4816 E 3Rd St
Los Angeles, CA 90022-1602

Phone

(323) 780-4510

NPI assigned

Jul 15, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Compton, CA
  • NPI 1801028303
  NPD
• The Roads Foundation, Inc.

  • Community Health Clinic/Center
  • Compton, CA
  • NPI 1508278359
  NPD

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1376773184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221602",
            "telephone_number": "323-780-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "BEDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "22123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "61555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Gamble
• Ryan Renee Gamble
• Valerie Gamble
• Amanda Rose Gamboa, DO
• Angel Gamboa
• Desirae Gamboa
• Jessenia Gamboa
• Joanna A Gamboa, LCSW
• Kristy Elaine Gamboa, LCSW
• Noelia Gamboa

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.