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Provider Information for 1861051849

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

AMELIA IRENE GOMEZ

Gender: FEMALE

Individual NPI: 1861051849

Calendar   Last Updated:  2020-12-03
  Certification Date:  2020-12-03

Details

Name Value
NPI 1861051849
Enumeration Date 2019-06-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 290 IOOF AVE
GILROY, CA 95020-5204
United States

Phone: 408-846-2100 | Fax:
View Map External Link
Primary Practice Address 290 IOOF AVE
GILROY, CA 95020-5204
United States

Phone: 408-846-2100 | Fax:
View Map External Link
Secondary Practice Address 9360 N NAME UNO STE 130
GILROY, CA 95020-3535
United States

Phone: 408-438-9350 | 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 171M00000X - Case Manager/Care Coordinator
No 106S00000X - Behavior Technician