Gregory Peter Pandzic, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW105016 Issued in CA

Practice address

235 Olive St
Claremont, CA 91711-4926

Phone

(909) 917-3373

Fax

(909) 418-6937

NPI assigned

Jul 27, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1669925459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 OLIVE ST",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114926",
            "telephone_number": "909-917-3373",
            "fax_number": "909-418-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 OLIVE ST",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114926",
            "telephone_number": "909-917-3373",
            "fax_number": "909-418-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDZIC",
        "first_name": "GREGORY",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-27",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW105016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Claremont, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.