Active NPI
Gloria Lisa Garcia, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1689792277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 22963
- Practice address
- 4642 Zane St
Los Angeles, CA 90032-2040 - Phone
- (310) 867-3316
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 22963 | CA | Primary |
Addresses
Primary practice location
4642 Zane St
Los Angeles, CA 90032-2040
Mailing address
4642 Zane St
Los Angeles, CA 90032-2040
Phone (310) 867-3316
Other practice location 1
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 432-5185
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624752000000",
"number": "1689792277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4642 ZANE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900322040",
"telephone_number": "310-867-3316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4642 ZANE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900322040",
"telephone_number": "310-867-3316"
}
],
"practiceLocations": [
{
"address_1": "4211 Avalon Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900115622",
"country_code": "US",
"telephone_number": "323-432-5185",
"fax_number": "323-432-5086",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARCIA",
"first_name": "GLORIA LISA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2021-06-27",
"certification_date": "2021-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "22963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.