Healthcare Provider Details

I. General information

NPI: 1386552032
Provider Name (Legal Business Name): GABRIEL ROA GOMEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SUNSET RD
WELLESLEY MA
02482-4615
US

IV. Provider business mailing address

6 STRATHMORE RD
NATICK MA
01760-2419
US

V. Phone/Fax

Practice location:
  • Phone: 408-761-5565
  • Fax:
Mailing address:
  • Phone: 508-650-5940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: