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General NPI Number Information
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NPI Number | 1275789703
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Entity Type | Individual
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Provider Name | FRANCISCO GOMEZ PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 08/15/2008
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Provider Practice Location Address
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Address Line | 325 W. WASHINGTON ST. STE. 2, #117
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City | SAN DIEGO
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State | CA
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Zip | 92103
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Country | US
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Telephone | 619-518-4045
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Fax | 619-923-0000
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Provider Business Mailing Address
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Address Line | 325 W. WASHINGTON ST. STE. 2, #117
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City | SAN DIEGO
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State | CA
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Zip | 92103
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Country | US
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Telephone | 619-518-4045
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Fax | 619-923-0000
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 15682
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License Number State | CA
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