Healthcare Provider Details

I. General information

NPI: 1528926060
Provider Name (Legal Business Name): ALYSSA LEIGH GOMEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 CIVIC CT
CONCORD CA
94520-7914
US

IV. Provider business mailing address

3301 BUCHANAN RD UNIT 67
ANTIOCH CA
94509-4302
US

V. Phone/Fax

Practice location:
  • Phone: 510-433-1150
  • Fax:
Mailing address:
  • Phone: 209-430-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number703698
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number95678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: