Individual provider Active NPI

Adriana Aida Gomez, LMFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1174094932
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT109515 Issued in CA
Practice address
4785 N 1St St
Fresno, CA 93726-0513
Phone
(559) 448-4620
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT109515 CA Primary

Addresses

Primary practice location

4785 N 1St St
Fresno, CA 93726-0513

Mailing address

PO Box 644
Glendale, CA 91209-0644
Phone (626) 765-7495

Other practice location 1

12501 Imperial Hwy
Norwalk, CA 90650-3179
Phone (562) 807-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240730001978 CA Practitioner - Marriage and Family Therapist 1759828510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12501 Imperial Hwy
Suite 400
Norwalk, CA 90650-1419
Phone (562) 807-6100

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT109515CAMDMarriage & Family Therapist
109515CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 17, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince May 17, 2024 Accepting new patients

Locations

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1174094932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 644",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912090644",
            "telephone_number": "626-765-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260513",
            "telephone_number": "559-448-4620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12501 Imperial Hwy",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906503179",
            "country_code": "US",
            "telephone_number": "562-807-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ADRIANA",
        "middle_name": "AIDA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT109515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.