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Provider Information for 1063950640

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

MS. ALYSSA GOMEZ FNP

Gender: FEMALE

Individual NPI: 1063950640

Calendar   Last Updated:  2017-02-03
  Certification Date: 

Details

Name Value
NPI 1063950640
Enumeration Date 2017-02-03
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 15047 LOS GATOS BLVD #200
LOS GATOS, CA 95032-2054
United States

Phone: 408-364-6799 | Fax: 408-378-4510
View Map External Link
Primary Practice Address 15047 LOS GATOS BLVD #200
LOS GATOS, CA 95032-2054
United States

Phone: 408-364-6799 | Fax: 408-378-4510
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 363LF0000X - Nurse Practitioner Family CA 95006073