Healthcare Provider Details

I. General information

NPI: 1467371856
Provider Name (Legal Business Name): FRAN DAVID FABIAN GOMEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 N 1ST ST STE 112
FRESNO CA
93720-2986
US

IV. Provider business mailing address

2621 SHAFT ST
SELMA CA
93662-3368
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-0520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: