MEDICARE: CRISTAL 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
1	104100000X	Social Worker	SWB-2022-9011	NM

General Provider Information

NPI Number	:	1851014013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTAL GOMEZ

Provider Business Mailing Address
First Line	:	4169 MONTGOMERY BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-6742
Country	:	US
Telephone Number	:	505-261-9770
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 CARLISLE BLVD NE STE 105
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-1680
Country	:	US
Telephone Number	:	505-663-6343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2022
Last Update Date	:	12/10/2025

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Directions to “ CRISTAL GOMEZ ” Practice Location

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