Individual provider Active NPI

Eileen Martha Gomez, NP

  • Family Nurse Practitioner
  • Tustin, CA
National Provider Identifier
1013704568
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95035436 Issued in CA
Practice address
661 W 1St St Ste G
Tustin, CA 92780-2939
Phone
(714) 665-9890
Fax
(714) 665-9891
NPI assigned
Apr 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95035436 CA Primary

Addresses

Primary practice location

661 W 1St St Ste G
Tustin, CA 92780-2939

Mailing address

661 W 1St St Ste G
Tustin, CA 92780-2939
Phone (714) 665-9890

Other practice location 1

11180 Warner Ave Ste 353
Fountain Valley, CA 92708-7516
Phone (714) 968-6789

Other practice location 2

9918 Katella Ave Ste A-C
Anaheim, CA 92804-6465
Phone (714) 644-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703001135 CA Practitioner - Nurse Practitioner 6305359167 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95035436CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Families Together of Orange County CurrentSince Jun 1, 2025 Accepting new patients
Families Together of Orange County CurrentSince Jun 1, 2025 Accepting new patients
Families Together of Orange County PastSince Jan 21, 2024 Accepting new patients

Locations

9918 Katella Ave
Ste Ac
Anaheim, CA 92804
Phone (714) 644-9494

11180 Warner Ave
Ste 353
Fountain Vly, CA 92708
Phone (714) 751-3540

661 W 1st St
Tustin, CA 92780
Phone (714) 665-9890

661 W 1st St
Ste G
Tustin, CA 92780
Phone (714) 665-9890

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1013704568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST STE G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11180 Warner Ave Ste 353",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927087516",
            "country_code": "US",
            "telephone_number": "714-968-6789",
            "fax_number": "714-202-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9918 Katella Ave Ste A-C",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046465",
            "country_code": "US",
            "telephone_number": "714-644-9494",
            "fax_number": "714-644-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "EILEEN",
        "middle_name": "MARTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95035436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.