Individual provider Active NPI

Karla Ruth Gandiaga, PCSW

  • Clinical Social Worker
  • Rock Springs, WY
National Provider Identifier
1679836274
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PCSW-503 Issued in WY
Practice address
2300 Foothill Blvd
Rock Springs, WY 82901-5610
Phone
(307) 352-6677
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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 PCSW-503 WY Primary

Addresses

Primary practice location

2300 Foothill Blvd
Rock Springs, WY 82901-5610

Mailing address

125 Magnolia Cir
Rock Springs, WY 82901-4378
Phone (307) 871-6239

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
PCSW-503WYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1679836274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MAGNOLIA CIR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014378",
            "telephone_number": "307-871-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 FOOTHILL BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015610",
            "telephone_number": "307-352-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDIAGA",
        "first_name": "KARLA",
        "middle_name": "RUTH",
        "credential": "PCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "PCSW-503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.