Individual provider Active NPI

Vanessa Garcia

  • Mental Health Counselor
  • Pacoima, CA
National Provider Identifier
1932566346
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
81520 Issued in CA
Practice address
12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331
Phone
(818) 896-1161
Fax
(818) 896-5069
NPI assigned
Jan 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 81520 CA Primary

Addresses

Primary practice location

12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331

Mailing address

12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331-1393
Phone (818) 896-1161

Other identifiers 3

IdentifierTypeStateIssuer
6758MedicaidCA
7068MedicaidCA
7420MedicaidCA

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
I20240415001726 CA Practitioner - Clinical Social Worker 0446699169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81520CAMDMental Health Counselor
117904CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. CurrentSince Feb 21, 2024 Accepting new patients
Glenn Medical Center, LLC PastSince Feb 21, 2024 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (530) 889-7293

50 California St
Ste 1500
San Francisco, CA 94111
Phone (310) 648-0700

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, 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": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1932566346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD STE 200",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311393",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 VAN NUYS BLVD STE 200",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "91331",
            "telephone_number": "818-896-1161",
            "fax_number": "818-896-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "81520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6758",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacoima, CA

Sources for this page

Verify at the official NPI Registry.