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Provider Information for 1598340242

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

ALBERTO R GOMEZ

Gender: MALE

Individual NPI: 1598340242

Calendar   Last Updated:  2021-06-30
  Certification Date:  2021-06-30

Details

Name Value
NPI 1598340242
Enumeration Date 2021-03-15
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 3186 AIRWAY AVE STE A
COSTA MESA, CA 92626-4650
United States

Phone: 714-881-0427 | Fax:
View Map External Link
Primary Practice Address 3186 AIRWAY AVE STE A
COSTA MESA, CA 92626-4650
United States

Phone: 714-881-0427 | Fax:
View Map External Link
Secondary Practice Address 321 CASSIDY ST
OCEANSIDE, CA 92054-5314
United States

Phone: 760-721-2171 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
CONNECT URL Oceanside 321 CASSIDY ST
OCEANSIDE, CA 92054-5314
United States
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 103K00000X - Behavioral Analyst
No 101YM0800X - Counselor Mental Health