Healthcare Provider Details

I. General information

NPI: 1245030469
Provider Name (Legal Business Name): KAREN YESENIA GOMEZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 DOVER PKWY
DELANO CA
93215-3440
US

IV. Provider business mailing address

355 DOVER PKWY
DELANO CA
93215-3440
US

V. Phone/Fax

Practice location:
  • Phone: 661-725-2788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: