Individual provider Active NPI

Ada Gonzales

  • Social Worker
  • Santa Maria, CA
National Provider Identifier
1851867550
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
81034 Issued in CA
Practice address
901 S Broadway
Santa Maria, CA 93454-6603
Phone
(805) 614-9275
Fax
(805) 614-9285
NPI assigned
Oct 19, 2018
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 81034 CA Primary
Clinical Social Worker 1041C0700X 81034 CA

Addresses

Primary practice location

901 S Broadway
Santa Maria, CA 93454-6603

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8028

Other practice location 1

218 Carmen Ln
Santa Maria, CA 93458-7772
Phone (805) 901-0123

Other identifiers 1

IdentifierTypeStateIssuer
83-3626059MedicaidCA

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
I20181203002347 CA Practitioner - Clinical Social Worker 4082958020 Reassigns benefits to 2 organizations
Practice locations: Santa Maria, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1145 E Clark Ave
Suite K
Santa Maria, CA 93455-5173
Phone (805) 203-6202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81034CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Oct 22, 2018 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Ada E Gonzales , LCSW Inc Clinical CurrentSince Sep 24, 2019 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Oct 22, 2018 Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

1145 E Clark Ave
Ste K
Santa Maria, CA 93455
Phone (805) 203-6202

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

218 Carmen Ln
Ste 108
Santa Maria, CA 93458
Phone (805) 901-0123

901 S Broadway
Santa Maria, CA 93454
Phone (805) 614-9275

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1851867550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8028",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S BROADWAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546603",
            "telephone_number": "805-614-9275",
            "fax_number": "805-614-9285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 Carmen Ln",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934587772",
            "country_code": "US",
            "telephone_number": "805-901-0123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ADA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "81034",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "81034",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83-3626059",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.