Active NPI
Keity Gomez
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1831592500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 95170
- Practice address
- 510 S Vermont Ave
Los Angeles, CA 90020-1912 - Phone
- (909) 450-3225
- NPI assigned
- Oct 8, 2014
- 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 | 95170 | CA | Primary |
Addresses
Primary practice location
510 S Vermont Ave
Los Angeles, CA 90020-1912
Mailing address
2360 S Via Veranda Unit 13
Ontario, CA 91762-6685
Phone (909) 450-3225
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 |
|---|---|---|---|
| 95170 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heritage Group Homes Inc. | Past | Accepting new patients | |
| Heritage Group Homes, Inc. | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1346804432
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- West Covina, CA
- NPI 1306398185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1831592500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2360 S VIA VERANDA UNIT 13",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917626685",
"telephone_number": "909-450-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "909-450-3225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "KEITY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-08",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "95170",
"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 Sep 27, 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.