Meliza Maria Gandara, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

126259 Issued in CA

Practice address

5000 Birch St Ste 3000
Newport Beach, CA 92660-2140

Phone

(877) 421-1711

Fax

(949) 576-3913

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tri-City Mental Health Authority

  • Community/Behavioral Health Agency
  • Pomona, CA
  • NPI 1346304920
  NPD
• Tri-City Mental Health Center

  • Case Management Agency
  • Pomona, CA
  • NPI 1255651501
  NPD (past)

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1891346433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672722",
            "telephone_number": "909-623-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BIRCH ST STE 3000",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602140",
            "telephone_number": "877-421-1711",
            "fax_number": "949-576-3913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 E Main St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927804414",
            "country_code": "US",
            "telephone_number": "818-741-6068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30211 Avenida De Las Bandera Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rancho Santa Margarita",
            "state": "CA",
            "postal_code": "926882159",
            "country_code": "US",
            "telephone_number": "877-421-1711",
            "fax_number": "949-576-3913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDARA",
        "first_name": "MELIZA",
        "middle_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "126259",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaely Brianda Galvan
• Yuliana Gamez
• Gamma Management Partners LLC
• Gamma Neuro Diagnostics Inc
• Faziela Gandara, NP
• Michelle Gandawidjaja
• Radhakrishan S Gandhi, M.D.
• Beckett Charles Gandolfi, PT, DPT
• Raeika Ganji
• Avro Gaon, MD

• Clinical Social Worker in Newport Beach, CA
• Providers in Newport Beach, 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 Oct 14, 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.