Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | ASW64201 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1184976763 |
---|---|
Provider Name | Francisca Gomez |
First Address | El Centro, CA 92243-2302 |
Second Address | El Centro, CA 92243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2012 |
Last Update Date | 22/01/2016 |