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NPI Code Detail

MEDICARE: JOANNA GOMEZ

MEDICARE: JOANNA 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1255890687
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA GOMEZ
Provider Business Mailing Address
First Line : 44 S MENTOR AVE
Second Line :
City : PASADENA
State : CA
Zip : 91106-2902
Country : US
Telephone Number : 626-506-0090
Fax Number :
Provider Business Practice Location Address
First Line : 44 S MENTOR AVE
Second Line :
City : PASADENA
State : CA
Zip : 91106-2902
Country : US
Telephone Number : 626-506-0090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2019
Last Update Date : 09/05/2025

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Directions to “ JOANNA GOMEZ ” Practice Location

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