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NPI Code Detail

MEDICARE: JASMINE GOMEZ

MEDICARE: JASMINE GOMEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist159800CA
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1124598313
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE GOMEZ
Provider Business Mailing Address
First Line : 6736 LAUREL CANYON BLVD STE 200
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-1576
Country : US
Telephone Number : 818-755-8786
Fax Number :
Provider Business Practice Location Address
First Line : 6736 LAUREL CANYON BLVD STE 200
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-1576
Country : US
Telephone Number : 818-755-8786
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2018
Last Update Date : 12/01/2025

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Directions to “ JASMINE GOMEZ ” Practice Location

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