Individual provider Active NPI

Gloria Marta Valenzuela, LCSW

  • Clinical Social Worker
  • Chula Vista, CA
National Provider Identifier
1679653380
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22926 Issued in CA
Practice address
2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557
Phone
(858) 279-1223
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22926 CA Primary

Addresses

Primary practice location

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Mailing address

2300 Boswell Rd Ste 275
Chula Vista, CA 91914-3557

Other practice location 1

5855 Streamview Dr.
San Diego, CA 92105
Phone (619) 287-5460

Other identifiers 1

IdentifierTypeStateIssuer
FHC18880FOtherCAMEDI CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000332 CA Practitioner - Clinical Social Worker 0143320200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare Inc CurrentSince Oct 4, 2021 Accepting new patients
The Twelfth Step House of San Diego, Inc. PastSince Jun 1, 2021 Accepting new patients

Locations

2300 Boswell Rd
Ste 275
Chula Vista, CA 91914
Phone (585) 898-0612

4160 Temescal Canyon Rd
Ste 205
Corona, CA 92883

4550 Kearny Villa Rd
Ste 116
San Diego, CA 92123
Phone (619) 279-1223

4540 Kearny Villa Rd
Ste 103
San Diego, CA 92123
Phone (858) 259-1223

31573 Rancho Pueblo Rd
Ste 200
Temecula, CA 92592

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1679653380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BOSWELL RD STE 275",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143557",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5855 Streamview Dr.",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92105",
            "country_code": "US",
            "telephone_number": "619-287-5460",
            "fax_number": "619-287-5040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "GLORIA",
        "middle_name": "MARTA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "22926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "FHC18880F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.