Doreatha Yvonne Gandy-Edmundson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

91993 Issued in CA

Practice address

420 N Twin Oaks Valley Rd # 318
San Marcos, CA 92069-1709

Phone

(858) 472-5497

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1396364071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N TWIN OAKS VALLEY RD # 318",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691709",
            "telephone_number": "858-472-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N TWIN OAKS VALLEY RD # 318",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691709",
            "telephone_number": "858-472-5497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1738 S Tremont St",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920545309",
            "country_code": "US",
            "telephone_number": "760-439-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDY-EDMUNDSON",
        "first_name": "DOREATHA",
        "middle_name": "YVONNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Gagliardi
• Jessica Gall, RN
• Martha Gallo
• Maria Ysela Galvan-Dupree, MFTI
• Stephanie Galvez
• Mary Jeness Ganguli, BCBA
• Kaitlyn Ganley
• Breanne Gannaway
• Ashley Garber, D.P.T.
• John Donald Garbrecht, DPT

• Clinical Social Worker in San Marcos, CA
• Providers in San Marcos, 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 Jul 1, 2025; 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.