Pink Moon HC a Licensed Clinical Social Worker Corporation

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

PINK MOON HC A LICENSED CLINICAL SOCIAL WORKER CORPORATION

Practice address

341 N Reno St
Los Angeles, CA 90026-4507

Phone

(213) 703-6234

NPI assigned

Oct 10, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Aubri Gomez, LCSWNPI 1356796395

Title

Founder/Psychotherapist

Phone

(213) 703-6234

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Aubri Gomez, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1356796395
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1659191179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 N RENO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264507",
            "telephone_number": "213-703-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 N RENO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264507",
            "telephone_number": "213-703-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINK MOON HC A LICENSED CLINICAL SOCIAL WORKER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "AUBRI",
        "authorized_official_title_or_position": "FOUNDER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "213-703-6234",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ping on Pharmacy Inc (Ping on Medical Pharmacy)
• Isabel Victoria Pingel
• Emily Pinho
• Stephanie A Pinilla, LCSW
• Pink Lotus Health Care Corp.
• Jamaal Jai Pink
• Alexandrea Marie Pinkerton
• Cipriano Edward Pinkney, BA SOCIAL WORK
• Alexandra Pinkus, MA, AMFT
• Pinnacle Gastroenterology Medical Associates

• Public Health or Welfare Agency in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Public Health or Welfare Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.