Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 95016043 | CA |
NPI | 1073103016 |
---|---|
Provider Name | Valerie Gomez |
First Address | Huntington Beach, CA 92648-2996 |
Second Address | Huntington Beach, CA 92648-5994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2021 |
Last Update Date | 11/02/2022 |