Individual provider Active NPI

Gina Mendez, MSW, LCSW

  • Clinical Social Worker
  • Temecula, CA
National Provider Identifier
1417278706
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
71515 Issued in CA
Practice address
28581 Old Town Front St
Ste 201
Temecula, CA 92590-2724
Phone
(951) 399-2810
Fax
(909) 363-9255
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9774-C NV
Clinical Social Worker 1041C0700X 71515 CA Primary

Addresses

Primary practice location

28581 Old Town Front St
Ste 201
Temecula, CA 92590-2724

Mailing address

42947 Beamer CT
Temecula, CA 92592-6625
Phone (951) 855-4967

Other practice location 1

10775 Pioneer Trl Ste 215
Truckee, CA 96161-0234
Phone (415) 424-4266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802001681 CA Practitioner - Clinical Social Worker 6305258740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9774-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gaits to Healing Clinical Current Accepting new patients

Locations

31045 Temecula Pkwy
Ste 204
Temecula, CA 92592
Phone (951) 216-3303

Interoperability endpoints

  • Direct secure messaging: gina.mendez.1@24284.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1417278706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42947 BEAMER CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926625",
            "telephone_number": "951-855-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28581 OLD TOWN FRONT ST",
            "address_2": "STE 201",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902724",
            "telephone_number": "951-399-2810",
            "fax_number": "909-363-9255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10775 Pioneer Trl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961610234",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "GINA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9774-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "71515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.