Individual provider Active NPI

Jessica Paola Gomez, PHARMD

  • Pharmacist
  • Sacramento, CA
National Provider Identifier
1053752667
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
53196 Issued in TX
Practice address
2221 Stockton Blvd RM 1130
Sacramento, CA 95817-1418
Phone
(916) 734-0900
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 70708 CA
Pharmacist 183500000X 53196 TX Primary

Addresses

Primary practice location

2221 Stockton Blvd RM 1130
Sacramento, CA 95817-1418

Mailing address

2221 Stockton Blvd RM 1130
Sacramento, CA 95817-1418
Phone (916) 734-0900

Other identifiers 2

IdentifierTypeStateIssuer
70708OtherCACALIFORNIA STATE BOARD OF PHARMACY
53196OtherTXTEXAS STATE BOARD OF PHARMACY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
70708CAMDPharmacist
53196TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California PastSince Jan 1, 2022 Accepting new patients
Regents of the University of California Past Accepting new patients

Organizations & group practices 2

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1053752667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 STOCKTON BLVD RM 1130",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171418",
            "telephone_number": "916-734-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 STOCKTON BLVD RM 1130",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171418",
            "telephone_number": "916-734-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JESSICA",
        "middle_name": "PAOLA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70708",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "53196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE BOARD OF PHARMACY",
            "identifier": "70708",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "53196",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.