Gavin K Madeira, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123910 Issued in CA

Practice address

550 W Vista Way
Vista, CA 92083-5732

Phone

(760) 758-1092

NPI assigned

Apr 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1780248609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 SUMAC PL",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920575423",
            "telephone_number": "760-390-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835732",
            "telephone_number": "760-758-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Mission Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920587110",
            "country_code": "US",
            "telephone_number": "760-305-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADEIRA",
        "first_name": "GAVIN",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97560",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "123910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarisse Mackay, FNP-C
• Colleen Mackay, PHARM.D.
• Michelle Farida Macklin
• Michael Lawrence Macmurray, M.D.
• Noel Madbak
• Madeline L Slater MD Inc
• Yolanda Madrid, RDH
• Elisa Magana
• Nathalie Esther Magnus
• Amy Francis Todd Magnuson, M.D.

• Clinical Social Worker in Vista, CA
• Providers in Vista, 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 Jun 11, 2025; 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.