Individual provider Active NPI

Alyssa Gomez, FNP

  • Family Nurse Practitioner
  • Los Gatos, CA
National Provider Identifier
1063950640
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006073 Issued in CA
Practice address
15047 Los Gatos Blvd
#200
Los Gatos, CA 95032-2054
Phone
(408) 364-6799
Fax
(408) 378-4510
NPI assigned
Feb 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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 95006073 CA Primary

Addresses

Primary practice location

15047 Los Gatos Blvd
#200
Los Gatos, CA 95032-2054

Mailing address

15047 Los Gatos Blvd
#200
Los Gatos, CA 95032-2054
Phone (408) 364-6799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95006073CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1063950640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15047 LOS GATOS BLVD",
            "address_2": "#200",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322054",
            "telephone_number": "408-364-6799",
            "fax_number": "408-378-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15047 LOS GATOS BLVD",
            "address_2": "#200",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322054",
            "telephone_number": "408-364-6799",
            "fax_number": "408-378-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ALYSSA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.