Individual provider Active NPI

Priscilla Gales, LCSW

  • Clinical Social Worker
  • Gardena, CA
National Provider Identifier
1841789922
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
79410 Issued in CA
Practice address
12915 Daphne Ave
Gardena, CA 90249-1603
Phone
(951) 203-1917
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 79410 CA Primary

Addresses

Primary practice location

12915 Daphne Ave
Gardena, CA 90249-1603

Mailing address

222 N Pacific Coast Hwy Ste 2000
El Segundo, CA 90245-5614
Phone (951) 203-1917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706001874 CA Practitioner - Clinical Social Worker 6204295496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12915 Daphne Ave
Gardena, CA 90249-1603
Phone (424) 326-3984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Priscilla Psy D Licensed Clinical Social Worker Corp Clinical CurrentSince Apr 19, 2023 Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 2000
El Segundo, CA 90245
Phone (323) 892-4082

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1841789922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2000",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455614",
            "telephone_number": "951-203-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12915 DAPHNE AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902491603",
            "telephone_number": "951-203-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALES",
        "first_name": "PRISCILLA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.