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NPI Code Detail

MEDICARE: SHIERLY JEANETTE GOMEZ

MEDICARE: SHIERLY JEANETTE GOMEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor21245CA

General Provider Information

NPI Number : 1245068352
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIERLY JEANETTE GOMEZ
Provider Business Mailing Address
First Line : 200 MICHIGAN AVE
Second Line :
City : VISTA
State : CA
Zip : 92084-5424
Country : US
Telephone Number : 760-726-4900
Fax Number :
Provider Business Practice Location Address
First Line : 200 MICHIGAN AVE
Second Line :
City : VISTA
State : CA
Zip : 92084-5424
Country : US
Telephone Number : 760-726-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 06/02/2026

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Directions to “ SHIERLY JEANETTE GOMEZ ” Practice Location

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