Gloria Consuelo Villagomez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80661 Issued in CA

Practice address

9828 Central Ave
Montclair, CA 91763-2817

Phone

(909) 447-7520

NPI assigned

Oct 20, 2020

Last updated

Feb 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Bienvenidos Children's Center, Inc

  • Community/Behavioral Health Agency
  • Montclair, CA
  • NPI 1548392178
  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1386243475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 COLORADO BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411744",
            "telephone_number": "323-543-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9828 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632817",
            "telephone_number": "909-447-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGOMEZ",
        "first_name": "GLORIA",
        "middle_name": "CONSUELO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Vergara Jimenez
• Lizbeth Sison Vicencio-Regner, MD
• Joseph Alika Viena
• Darrin Villa-Howells
• Jason Villa
• Deanna Villalobos
• Alexus Ayanna Villanueva
• Ivette Villarreal
• Sabrina Nikole Villasenor
• Jelene Aira Lintag Villegas

• Clinical Social Worker in Montclair, CA
• Providers in Montclair, 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 Feb 23, 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.

Verify at the official NPI Registry.