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Provider Information for 1750944872

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

ALEXANDRIA M GOMEZ

Gender: FEMALE

Individual NPI: 1750944872

Calendar   Last Updated:  2021-07-12
  Certification Date:  2021-07-12

Details

Name Value
NPI 1750944872
Enumeration Date 2019-04-15
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
United States

Phone: 949-833-2237 | Fax:
View Map External Link
Primary Practice Address 17595 ALMAHURST ST STE 100A
CITY OF INDUSTRY, CA 91748-1792
United States

Phone: 855-223-7123 | 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 106S00000X - Behavior Technician