Active NPI
Gina Haase, LCSW
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1760866412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7317-123
- Practice address
- 450 Bauchet St
Los Angeles, CA 90012-2907 - Phone
- (213) 813-5559
- NPI assigned
- Jul 13, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7317-123 | WI | Primary |
Addresses
Primary practice location
450 Bauchet St
Los Angeles, CA 90012-2907
Mailing address
829 Broadway Ste 117
Santa Monica, CA 90401-3546
Phone (414) 510-5043
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 |
|---|---|---|---|
| 7317-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1760866412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "829 BROADWAY STE 117",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904013546",
"telephone_number": "414-510-5043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 BAUCHET ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900122907",
"telephone_number": "213-813-5559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAASE",
"first_name": "GINA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7317-123",
"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 Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.