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Provider Information for 1124572748

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

AMY GOMEZ KARR

Other Name:   AMY GOMEZ CASTANEDA
Gender: FEMALE

Individual NPI: 1124572748

Calendar   Last Updated:  2021-10-05
  Certification Date:  2021-10-05

Details

Name Value
NPI 1124572748
Enumeration Date 2016-08-11
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 333 S BEAUDRY AVE
LOS ANGELES, CA 90017-1466
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 333 S BEAUDRY AVE
LOS ANGELES, CA 90017-1466
United States

Phone: 213-241-3841 | 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 101YM0800X - Counselor Mental Health CA 90710