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NPI Code Detail

MEDICARE: MAYA SUTTA-GOMEZ

MEDICARE: MAYA SUTTA-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
11041C0700XClinical Social Worker134206CA

General Provider Information

NPI Number : 1801405972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA SUTTA-GOMEZ
Provider Business Mailing Address
First Line : 3101 OCEAN PARK BLVD STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3029
Country : US
Telephone Number : 323-383-7765
Fax Number :
Provider Business Practice Location Address
First Line : 3101 OCEAN PARK BLVD STE 100
Second Line :
City : SANTA MONICA
State : CA
Zip : 90405-3029
Country : US
Telephone Number : 323-383-7765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2020
Last Update Date : 11/07/2025

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Directions to “ MAYA SUTTA-GOMEZ ” Practice Location

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