Juan Gomez, CAADE CATC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2090 Commerce Ave
Concord, CA 94520-4902

Phone

(925) 676-2580

Fax

(925) 676-1315

NPI assigned

Jan 8, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bibett

  • Substance Abuse Rehabilitation Facility
  • Concord, CA
  • NPI 1922205046
  NPD (past)

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

{
    "created_epoch": "1483833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1164968699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 COMMERCE AVE",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204902",
            "telephone_number": "925-676-2580",
            "fax_number": "925-676-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 COMMERCE AVE",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204902",
            "telephone_number": "925-676-2580",
            "fax_number": "925-676-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JUAN",
        "credential": "CAADE CATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-08",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "169084",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAADE",
            "identifier": "169084",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwin Gomez, SUDRC I
• Elizabeth Marie Gomez
• Gabriel Gomez
• Halie Gomez
• Joellen Caroline Gomez
• Kimberly Gomez
• Monica Gomez
• Nayely Gomez
• Philip James Gomez Jr., P.T.
• Ramon Joseph Gomez

• Mental Health Counselor in Concord, CA
• Providers in Concord, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.