Healthcare Provider Details

I. General information

NPI: 1205748167
Provider Name (Legal Business Name): MRS. CHRISTEN MARIE GOMEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 K ST
REEDLEY CA
93654-3331
US

IV. Provider business mailing address

1801 10TH ST
REEDLEY CA
93654-2934
US

V. Phone/Fax

Practice location:
  • Phone: 155-930-5727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number42096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: