Individual provider Active NPI

Pedro Luis Gomez Gomez, CMT

  • Massage Therapist
  • Santa Rosa, CA
National Provider Identifier
1104782366
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
96887 Issued in CA
Practice address
1049 Aston Cir
Santa Rosa, CA 95404-6006
Phone
(707) 360-5829
NPI assigned
Dec 31, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 96887 CA Primary

Addresses

Primary practice location

1049 Aston Cir
Santa Rosa, CA 95404-6006

Mailing address

1049 Aston Cir
Santa Rosa, CA 95404-6006
Phone (707) 360-5829

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

State licenses

LicenseStateTypeSpecialty
96887CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1767139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1104782366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 ASTON CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046006",
            "telephone_number": "707-360-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 ASTON CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046006",
            "telephone_number": "707-360-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ GOMEZ",
        "first_name": "PEDRO",
        "middle_name": "LUIS",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-31",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "96887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.