Mirza Corina Lopez Gallegos, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Santa Fe Springs, California. Her current practice location is
11721 Telegraph Rd, Santa Fe Springs, California. You can reach out to her office (for appointments etc.) via phone at
(562) 949-8455.
Mirza Corina Lopez Gallegos is licensed to practice in California (license number LCSW74959) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1093946139.
Healthcare Provider's Profile
| Full Name | Mirza Corina Lopez Gallegos |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 11721 Telegraph Rd, Santa Fe Springs, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1093946139
- Provider Enumeration Date: 08/06/2009
- Last Update Date: 01/12/2022
Medicare PECOS Information:
- PECOS PAC ID: 4981980133
- Enrollment ID: I20170424002222
Medical Identifiers
Medical identifiers for Mirza Corina Lopez Gallegos such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093946139 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| 225400000X | Rehabilitation Practitioner | B9907603 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW74959 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mirza Corina Lopez Gallegos allows following entities to bill medicare on her behalf.
| Entity Name | Pacific Clinics |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255496105
PECOS PAC ID: 4082008420
Enrollment ID: O20220228001926 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mirza Corina Lopez Gallegos is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mirza Corina Lopez Gallegos, LCSW
11721 Telegraph Rd,
Santa Fe Springs, CA 90670-3674
Ph: (562) 949-8455 | Mirza Corina Lopez Gallegos, LCSW
11721 Telegraph Rd,
Santa Fe Springs, CA 90670-3674
Ph: (562) 949-8455 |
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