AUDRIE LEIGH GORDON (NPI# 1164857991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164857991 |
| Entity Type | Individual |
| Full Name | AUDRIE LEIGH GORDON |
| Practice Address |
614 W Manchester Blvd 104 Inglewood CA 90301-1656 |
| Practice Telephone | 3104120879 |
| Mailing Telephone | 5623209139 |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2016-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
614 W MANCHESTER BLVD 104 |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90301-1656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609926336 | Alicia Brooke Van Ooyen | Counselor | 614 W Manchester Blvd, Inglewood, CA 90301-1656 | 2007-01-12 |
| 1942726153 | Lauren Dorothy Plummer | Counselor | 614 W Manchester Blvd, Inglewood, CA 90301-1656 | 2017-08-18 |
| 1710434956 | Latreice Milner | Counselor | 614 W Manchester Blvd, 104, Inglewood, CA 90301-1656 | 2016-09-06 |
| 1548646110 | Erika Williams | Counselor | 614 W Manchester Blvd, Inglewood, CA 90301-1656 | 2015-08-06 |
| 1841687498 | Christine Fredricks | Counselor | 614 W Manchester Blvd, Ste. 104, Inglewood, CA 90301-1656 | 2015-04-22 |
| 1679919419 | Aegis Treatment Centers, LLC | Clinic/Center | 614 W Manchester Blvd, #104, Inglewood, CA 90301-1656 | 2013-05-20 |
| 1013352970 | George Abraham | Counselor | 614 W Manchester Blvd, Inglewood, CA 90301-1656 | 2013-05-06 |
| 1881937019 | Rebecca Ohabim | Counselor | 614 W Manchester Blvd, Inglewood, CA 90301-1656 | 2013-04-06 |
| 1689922932 | Cynthia Monica Laskowski | Counselor | 614 W Manchester Blvd, Inglewood, CA 90301-1656 | 2012-08-16 |
| 1154687028 | Jackie Winston | Counselor | 614 W Manchester Blvd, Suite 104, Inglewood, CA 90301-1656 | 2012-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548897945 | Genevieve V. Angel | Registered Nurse | 555 East Hardy Street, Director of Cm Sw, Centinela Hospital Medical Center, Inglewood, CA 90301 | 2020-03-25 |
| 1992338552 | Ralph Kevin Roque | Licensed Practical Nurse | 614 W Manchester Blvd, Inglewood, Ca 90301, 104, Inglewood, CA 90301 | 2020-02-21 |
| 1043841562 | Evelyn Jones | Social Worker | 555 E. Hardy Street, Inglewood, Ca, CA 90301 | 2020-02-03 |
| 1447896444 | Coral Dabarera Edelson | Dietitian, Registered | 110 North La Brea Ave, Inglewood, CA 90301 | 2019-11-25 |
| 1821642125 | Jennifer Robert Umoh | Student in an Organized Health Care Education/Training Program | 412 E Florence Avenue, Inglewood, CA 90301 | 2019-07-25 |
| 1821567751 | Esther Voltaire | Behavior Technician | 619 E Arbor Vitae St, Inglewood, CA 90301 | 2018-11-21 |
| 1902372832 | Pool Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 323 North Prairie Ave, Suite 200, Ingelwood, CA 90301 | 2018-10-18 |
| 1174003594 | Xelnt Healthcare Inc. | Clinic/Center | 501 E Hardy St Ste 425, Inglewood, CA 90301 | 2018-08-15 |
| 1710409321 | Rae Shelston Mcintosh | Licensed Vocational Nurse | 1007 Myrth Ave, Inglewood, CA 90301 | 2017-07-14 |
| 1477093789 | Lewis E Logan II | Counselor | 332 N. Prairie Ave., Suite 417, Inglewood, CA 90301 | 2017-03-06 |
| Find all providers in zip 90301 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389775 | Edward Mccarty | Counselor | 905 Glenway Dr Apt 5, Inglewood, CA 90302-2617 | 2020-09-04 |
| 1538603386 | Zina Love | Counselor | 241 S Market St Ste 4, Inglewood, CA 90301 | 2016-12-13 |
| 1477908044 | Raquel Montes | Counselor | 9722 Oceangate Avenue, Inglewood, CA 90301 | 2016-05-02 |
| 1740657345 | Raiji Gaines I | Counselor | 2030 W Imperial Hwy Suite 511, Inglewood, CA 90303 | 2015-08-31 |
| 1679955595 | Ronnie Salone | Counselor | 2930 W Imperial Hwy Ste 511, Inglewood, CA 90303-3139 | 2015-06-27 |
| 1699166405 | Hector Saucedo | Counselor | 323 N. Paririe Ave., Inglewood, CA 90301 | 2015-02-16 |
| 1295123883 | Ayesha Lewis Munir | Counselor | 2917 W 78th Pl, Inglewood, CA 90305-1027 | 2015-01-05 |
| 1659775302 | John Dennem | Counselor | 323 N. Praire Ave., Inglewood, CA 90301 | 2014-10-09 |
| 1376896217 | Guadalupe Torres | Counselor | 1210 S La Brea Ave Ste A, Inglewood, CA 90301-3894 | 2012-10-16 |
| 1740549526 | Abera Gebre | Counselor | 1210 S. Labrea Ave, Inglewood, CA 90301-3891 | 2012-05-14 |
| Find all providers in INGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.