Healthcare Provider Details

I. General information

NPI: 1013123330
Provider Name (Legal Business Name): GABRIELA P GOMEZ BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W ARRELLAGA ST
SANTA BARBARA CA
93101-2903
US

IV. Provider business mailing address

118 W ARRELLAGA ST
SANTA BARBARA CA
93101-2903
US

V. Phone/Fax

Practice location:
  • Phone: 805-962-2963
  • Fax: 805-962-2965
Mailing address:
  • Phone: 805-614-9535
  • Fax: 805-962-2965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: