Healthcare Provider Details

I. General information

NPI: 1679198741
Provider Name (Legal Business Name): PATRICIA GOMEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2020
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E WILLIAMS FIELD RD STE 200
GILBERT AZ
85295-0764
US

IV. Provider business mailing address

2200 E WILLIAMS FIELD RD STE 200
GILBERT AZ
85295-0764
US

V. Phone/Fax

Practice location:
  • Phone: 224-234-4478
  • Fax:
Mailing address:
  • Phone: 224-234-4478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-22152
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: