Alissa Jade Gomez

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

1405392966 Issued in NV

Practice address

5803 W Craig Rd
Las Vegas, NV 89130-2536

Phone

(702) 901-5200

NPI assigned

May 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Creative Behavioral Connections

  • Behavior Technician
  • Las Vegas, NV
  • NPI 1780421917
  NPD (past)
• Creative Behavioral Connections LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1750754107
  NPD (past)

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1043877194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 W CRAIG RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302536",
            "telephone_number": "702-901-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 W CRAIG RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302536",
            "telephone_number": "702-901-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ALISSA",
        "middle_name": "JADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "1405392966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Gomez-Venzor, CPC-I
• Kimberly Gomez-Zelaya
• Adriana Garcia Gomez
• Aileen Gomez
• Ailyn Gomez, F.N.P.
• Alma Alicia Gomez
• Amber Natalie Gomez
• Amy Teresa Gomez
• Angelica Gomez
• Angelica M Gomez

• Behavior Technician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Technician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.