Individual provider Active NPI

Gabriela Velasco

  • Addiction (Substance Use Disorder) Counselor
  • North Hills, CA
National Provider Identifier
1740794213
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
15305 Rayen St
North Hills, CA 91343-5117
Phone
(818) 892-3423
NPI assigned
Nov 20, 2017
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary
Rehabilitation Practitioner 225400000X NU

Addresses

Primary practice location

15305 Rayen St
North Hills, CA 91343-5117

Mailing address

15305 Rayen St
North Hills, CA 91343-5117
Phone (818) 892-3423

Other practice location 1

15315 Rayen St
North Hills, CA 91343-5117
Phone (818) 892-3423

Other practice location 2

15315 Rayen St
North Hills, CA 91343-5117
Phone (818) 892-3423

Other practice location 3

5628 E Slauson Ave
Commerce, CA 90040-2922
Phone (323) 318-9960

Other identifiers 1

IdentifierTypeStateIssuer
952633765OtherCAMEDI-CAL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Penny Lane Centers Past Accepting new patients
Penny Lane Centers Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1740794213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15315 Rayen St",
            "address_purpose": "LOCATION",
            "city": "North Hills",
            "state": "CA",
            "postal_code": "913435117",
            "country_code": "US",
            "telephone_number": "818-892-3423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15315 Rayen St",
            "address_purpose": "LOCATION",
            "city": "North Hills",
            "state": "CA",
            "postal_code": "913435117",
            "country_code": "US",
            "telephone_number": "818-892-3423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5628 E Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900402922",
            "country_code": "US",
            "telephone_number": "323-318-9960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "GABRIELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "952633765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.