Individual provider Active NPI

Jeanette Gomez Velazco

  • Addiction (Substance Use Disorder) Counselor
  • Los Angeles, CA
National Provider Identifier
1467331280
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1628270825 Issued in CA
Practice address
4099 N Mission Rd
Los Angeles, CA 90032-2697
Phone
(323) 221-1746
Fax
(323) 221-5176
NPI assigned
Aug 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1628270825 CA Primary

Addresses

Primary practice location

4099 N Mission Rd
Los Angeles, CA 90032-2697

Mailing address

4099 N Mission Rd
Los Angeles, CA 90032-2697
Phone (323) 221-1746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1628270825CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1467331280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4099 N MISSION RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900322697",
            "telephone_number": "323-221-1746",
            "fax_number": "323-221-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4099 N MISSION RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900322697",
            "telephone_number": "323-221-1746",
            "fax_number": "323-221-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ VELAZCO",
        "first_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1628270825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.