Active NPI
Gwendolyn Lopez
- Clinical Social Worker
- San Luis Obispo, CA
National Provider Identifier
1689159204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 121130
- Practice address
- Highway 1
San Luis Obispo, CA 93403-8101 - Phone
- (805) 547-7900
- NPI assigned
- Sep 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 96946 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | ASW96946 | CA | |
| Clinical Social Worker | 1041C0700X | 121130 | CA | Primary |
Addresses
Primary practice location
Highway 1
San Luis Obispo, CA 93403-8101
Mailing address
PO Box 8101
San Luis Obispo, CA 93403-8101
Phone (805) 547-7900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 121130 | CA | MD | Clinical Social Worker |
| 96946 | CA | MD | Student in an Organized Health Care Education/Training Program |
| ASW96946 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1689159204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8101",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934038101",
"telephone_number": "805-547-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HIGHWAY 1",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934038101",
"telephone_number": "805-547-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "GWENDOLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-28",
"last_updated": "2024-03-20",
"certification_date": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "96946",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "ASW96946",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "121130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.