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Provider Information for 1366932063

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

AMANDA GOMEZ AMFT

Gender: FEMALE

Individual NPI: 1366932063

Calendar   Last Updated:  2018-08-17
  Certification Date: 

Details

Name Value
NPI 1366932063
Enumeration Date 2018-05-17
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1393 BAILEY ST
HANFORD, CA 93230-5922
United States

Phone: 559-904-9977 | Fax:
View Map External Link
Primary Practice Address 1393 BAILEY ST
HANFORD, CA 93230
United States

Phone: 559-904-9977 | 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 106H00000X - Marriage & Family Therapist CA IMF108312
No 193400000X SINGLE SPECIALTY GROUP
106H00000X - Marriage & Family Therapist