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Provider Information for 1013683549

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALEX GOMEZ RBT

Gender: MALE

Individual NPI: 1013683549

Calendar   Last Updated:  2021-08-16
  Certification Date:  2021-08-16

Details

Name Value
NPI 1013683549
Enumeration Date 2021-08-16
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1000 PASEO CAMARILLO STE 235
CAMARILLO, CA 93010-0754
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 1000 PASEO CAMARILLO STE 235
CAMARILLO, CA 93010-0754
United States

Phone: 805-385-5566 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 106S00000X - Behavior Technician