Lourdes Carolina Gomez, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86169226 Issued in CA

Practice address

9612 Helena Ave
Montclair, CA 91763-2210

Phone

(909) 541-8612

NPI assigned

Jul 15, 2021

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Wilmington, CA
  • NPI 1700097540
  Medicare reassignment NPD
• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1275226334
  NPD
• Northeast Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1851942288
  NPD

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1104498328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 E 11TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908046430",
            "telephone_number": "909-541-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9612 HELENA AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632210",
            "telephone_number": "909-541-8612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 S Grand Ave Ste 380",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153072",
            "country_code": "US",
            "telephone_number": "888-311-6322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "LOURDES",
        "middle_name": "CAROLINA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86169226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Shellese Gomez
• Daniela Paola Gomez
• Desiree Marie Gomez
• Estefany Gomez
• Jamie Gomez
• Melissa Gomez
• Savanna Gomez
• Eveline Gonsalez
• Rudy Gabriel Gonzales III
• Raymond Gonzalez Martinez

• Registered Dietitian in Montclair, CA
• Providers in Montclair, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.