Active NPI
Philip Gnaedig, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1730896234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 94516
- Practice address
- 917 Montecito Dr
Los Angeles, CA 90031-1633 - Phone
- (213) 374-0760
- NPI assigned
- Nov 3, 2022
- Sex
- Male
- 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 | 94516 | CA | Primary |
Addresses
Primary practice location
917 Montecito Dr
Los Angeles, CA 90031-1633
Mailing address
4470 W Sunset Blvd
Suite 107 PMB 91813
Los Angeles, CA 90027
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 |
|---|---|---|---|
| 94516 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667433600000",
"number": "1730896234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4470 W SUNSET BLVD",
"address_2": "SUITE 107 PMB 91813",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 MONTECITO DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900311633",
"telephone_number": "213-374-0760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GNAEDIG",
"first_name": "PHILIP",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-03",
"last_updated": "2022-11-03",
"certification_date": "2022-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "94516",
"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 Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.