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General NPI Number Information
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NPI Number | 1447074620
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Entity Type | Individual
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Provider Name | CAROLINA ISABELL GOMEZ LVN
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Gender | Female
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 222 W 6TH ST
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City | CORONA
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State | CA
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Zip | 92882-3301
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Country | US
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Telephone | 888-682-6282
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Fax | 888-507-7087
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Provider Business Mailing Address
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Address Line | 1305 HARDT ST APT A
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-2939
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Country | US
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Telephone | 909-496-7359
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Fax |
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 706404
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License Number State | CA
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