Stephanie Alina Gomez, OPT

Primary specialty

OpticianTaxonomy code 156FX1800X

License

40706 Issued in CA

Practice address

228 W Hospitality LN Ste F2
San Bernardino, CA 92408-3268

Phone

(909) 234-5257

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1073166484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2273 CRESCENT CIR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923249515",
            "telephone_number": "909-234-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W HOSPITALITY LN STE F2",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083268",
            "telephone_number": "909-234-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "STEPHANIE",
        "middle_name": "ALINA",
        "credential": "OPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "40706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unitedspecsoptical@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "228 W Hospitality Ln",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924083206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lizette Gomez
• Manuel Acosta Gomez
• Martha Gomez
• Rebecca Gomez
• Rosemarie Minera Gomez, M.S.W.
• Yanelly V Gomez
• Richelle Mianne Daug Gonzaga
• Breanda Gonzales-Rosales
• Adriana Arizpe Gonzales, MFT
• Chaquita L Gonzales

• Optician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.