Ada E Gonzales , LCSW Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ADA E GONZALES , LCSW INC

Practice address

1145 E Clark Ave Ste K
Santa Maria, CA 93455-5173

Phone

(805) 203-6202

NPI assigned

Jul 31, 2019

Organization subpart

No

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

Authorized official

Name

Ada Gonzales, L.C.S.WNPI 1851867550

Title

President

Phone

(805) 203-6202

Specialties & licenses 1

Addresses

Other names 1

• Ada E Gonzales, LCSW Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ada Gonzales

  • Social Worker
  • Santa Maria, CA
  • NPI 1851867550

  CA, Clinical

  Medicare reassignment NPD Authorized official
• Caitlin Johnson, RD

  • Registered Dietitian
  • Santa Maria, CA
  • NPI 1134671274
  NPD (past)

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575590400000",
    "number": "1447804133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 MCCLOUD ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934557108",
            "telephone_number": "805-203-6202",
            "fax_number": "855-617-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 E CLARK AVE STE K",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555173",
            "telephone_number": "805-203-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA E GONZALES , LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-12-06",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "ADA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-203-6202",
        "authorized_official_credential": "L.C.S.W"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ada E Gonzales, LCSW Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ada E Gonzales, LCSW Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Carrick Jean Adam, M.D., M.S.P.H
• John Michael Adam, DMD

• All providers in Santa Maria, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.