Individual provider Active NPI

Gustavo Lucas Preciado

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1922479807
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
131913 Issued in CA
Practice address
1701 E Cesar E Chavez Ave Ste 532
Los Angeles, CA 90033-2496
Phone
(323) 545-3522
NPI assigned
Oct 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 97393 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 131913 CA Primary
Mental Health Counselor 101YM0800X 97393 CA

Addresses

Primary practice location

1701 E Cesar E Chavez Ave Ste 532
Los Angeles, CA 90033-2496

Mailing address

3031 S Vermont Ave
Los Angeles, CA 90007-3033
Phone (323) 373-2400

Other practice location 1

333 S Beaudry Ave
Los Angeles, CA 90017
Phone (213) 241-3841

Other practice location 2

3787 S Vermont Ave
Los Angeles, CA 90007-4203
Phone (323) 766-2345

Other practice location 3

4401 Crenshaw Blvd
Los Angeles, CA 90043-1227
Phone (323) 290-8360

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

LicenseStateTypeSpecialty
131913CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnest Emotional Health & Wellness CurrentSince Nov 1, 2020 Accepting new patients

Locations

4401 Crenshaw Blvd
Los Angeles, CA 90043
Phone (323) 290-8360

3031 S Vermont Ave
Los Angeles, CA 90007
Phone (323) 766-2345

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": "1445040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1922479807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073033",
            "telephone_number": "323-373-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR E CHAVEZ AVE STE 532",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332496",
            "telephone_number": "323-545-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 S Beaudry Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90017",
            "country_code": "US",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3787 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900074203",
            "country_code": "US",
            "telephone_number": "323-766-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4401 Crenshaw Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900431227",
            "country_code": "US",
            "telephone_number": "323-290-8360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRECIADO",
        "first_name": "GUSTAVO",
        "middle_name": "LUCAS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-17",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97393",
            "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": "131913",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "97393",
            "primary": false
        }
    ],
    "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 Jul 23, 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.