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Provider Information for 1336814367

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

ALEJANDRA GOMEZ

Gender: FEMALE

Individual NPI: 1336814367

Calendar   Last Updated:  2021-08-11
  Certification Date:  2021-07-30

Details

Name Value
NPI 1336814367
Enumeration Date 2021-08-11
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 643 W 7TH ST APT 9
SAN PEDRO, CA 90731-3181
United States

Phone: 559-568-6876 | Fax:
View Map External Link
Primary Practice Address 643 W 7TH ST
SAN PEDRO, CA 90731-3166
United States

Phone: 559-568-6876 | 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 193400000X SINGLE SPECIALTY GROUP
171M00000X - Case Manager/Care Coordinator