Individual provider Active NPI

Yolanda Patricia Gomez, MSW, LCSW

  • Clinical Social Worker
  • Covina, CA
National Provider Identifier
1639681893
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113346 Issued in CA
Practice address
276 W College St
Covina, CA 91723-1902
Phone
(626) 919-4333
Fax
(626) 331-8526
NPI assigned
Oct 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 113346 CA Primary

Addresses

Primary practice location

276 W College St
Covina, CA 91723-1902

Mailing address

1555 S Garey Ave
Pomona, CA 91766-5222
Phone (626) 919-4333

Other practice location 1

5715 S Broadway
Los Angeles, CA 90037-4131
Phone (323) 948-0444

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
113346CAMDClinical Social Worker

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: yolanda.gomez.p1@direct.evchc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1639681893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 S GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665222",
            "telephone_number": "626-919-4333",
            "fax_number": "626-331-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 W COLLEGE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231902",
            "telephone_number": "626-919-4333",
            "fax_number": "626-331-8526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5715 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900374131",
            "country_code": "US",
            "telephone_number": "323-948-0444",
            "fax_number": "323-948-0443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "YOLANDA",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-27",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.