Individual provider Active NPI

Jessica Gallo, L.C.S.W.

  • Clinical Social Worker
  • Santa Monica, CA
National Provider Identifier
1699008987
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29343 Issued in CA
Practice address
1150 Yale St Ste 2
Santa Monica, CA 90403-4773
Phone
(424) 256-1899
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 26209 CA
Clinical Social Worker 1041C0700X 29343 CA Primary

Addresses

Primary practice location

1150 Yale St Ste 2
Santa Monica, CA 90403-4773

Mailing address

1150 Yale St Ste 2
Santa Monica, CA 90403-4773
Phone (424) 256-1899

Other practice location 1

1250 4th St
3rd Floor
Santa Monica, CA 90401-1366
Phone (310) 305-3135

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
29343CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1699008987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 YALE ST STE 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034773",
            "telephone_number": "424-256-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 YALE ST STE 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034773",
            "telephone_number": "424-256-1899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 4th St",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904011366",
            "country_code": "US",
            "telephone_number": "310-305-3135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLO",
        "first_name": "JESSICA",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "26209",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.