MEDICARE: MRS. ROSARIO GOMEZ M.A. SLP CCC

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
1	235Z00000X	Speech-Language Pathologist	28395	CA

General Provider Information

NPI Number	:	1356132401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSARIO GOMEZ M.A. SLP CCC

Provider Business Mailing Address
First Line	:	18031 MESCAL ST
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-4310
Country	:	US
Telephone Number	:	562-309-1544
Fax Number	:

Provider Business Practice Location Address
First Line	:	14135 FRANCISQUITO AVE
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-6107
Country	:	US
Telephone Number	:	562-360-8031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2025
Last Update Date	:	05/16/2025

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