Lauren Dakota Gamble

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120708 Issued in CA

Practice address

2255 Challenger Way
Santa Rosa, CA 95407-5423

Phone

(707) 565-4797

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Greenacre Homes, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Sebastopol, CA
  • NPI 1184396301
  NPD (past)
• Greenacre Homes, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Sebastopol, CA
  • NPI 1376209296
  NPD (past)

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1992424568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075423",
            "telephone_number": "707-565-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075423",
            "telephone_number": "707-565-4797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "438 Eddie Ln",
            "address_purpose": "LOCATION",
            "city": "Sebastopol",
            "state": "CA",
            "postal_code": "954723425",
            "country_code": "US",
            "telephone_number": "707-823-8722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "LAUREN",
        "middle_name": "DAKOTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "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": "120708",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Gallo, MSPT,CSCS
• Thai Lynn Gallo
• Wendy Galvan Tovar
• Panida Galviroj, D.M.D.
• Brian Gambardella, MD
• Michael Miller Gamble, M.D.
• Gabi Gannon
• John A. Gansel, MD
• Michael Appell Ganz, MD
• Claudia Maria Garate-House

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, 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 May 31, 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.