Lucero Gonzalez Chacon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110884 Issued in CA

Practice address

2033 S Crescent Ave
San Pedro, CA 90731-5512

Phone

(424) 417-1374

NPI assigned

Oct 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lucy Gonzalez Chacon Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1780227462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12653 IBBETSON AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902425049",
            "telephone_number": "562-417-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 S CRESCENT AVE",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907315512",
            "telephone_number": "424-417-1374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12501 Hawthorne Blvd",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "CA",
            "postal_code": "902504404",
            "country_code": "US",
            "telephone_number": "562-417-7713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACON",
        "first_name": "LUCERO",
        "middle_name": "GONZALEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2024-05-07",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1355620719",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LUCY",
            "last_name": "CHACON",
            "middle_name": "GONZALEZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karla Vanesa Cehua
• Minerva Ceja, TCH
• Doris Renee Celi, APRN
• Diana Centeno-Sicairos
• Denise Cervantes, AMFT
• Neil Ira Chafetz, M.D.
• Onintr Chanthanasuksilpa
• Matthew Chapin
• Charles Brown Healthcare, a Medical Corporation
• Charles Etuk

• Clinical Social Worker in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.