Healthcare Provider Details

I. General information

NPI: 1821376781
Provider Name (Legal Business Name): ARMIDA GOMEZ DELGADILLO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ARMIDA RODRIGUEZ GOMEZ

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2667 CAMINO DEL RIO S STE 102
SAN DIEGO CA
92108-3763
US

IV. Provider business mailing address

8030 LA MESA BLVD STE 25
LA MESA CA
91942-0335
US

V. Phone/Fax

Practice location:
  • Phone: 619-782-0700
  • Fax: 619-782-0710
Mailing address:
  • Phone: 619-782-0700
  • Fax: 619-782-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-37662
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: