Active NPI
Jeanette Viridiana Gomez, FNP
- Family Nurse Practitioner
- Oakland, CA
National Provider Identifier
1255725388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 836855
- Practice address
- 3022 International Blvd
Oakland, CA 94601-2224 - Phone
- (510) 261-1677
- NPI assigned
- Mar 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 836855 | CA | Primary |
Addresses
Primary practice location
3022 International Blvd
Oakland, CA 94601-2224
Mailing address
3022 International Blvd
Oakland, CA 94601-2224
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
| License | State | Type | Specialty |
|---|---|---|---|
| 836855 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453420800000",
"number": "1255725388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3022 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3022 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012224",
"telephone_number": "510-261-1677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "JEANETTE",
"middle_name": "VIRIDIANA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-26",
"last_updated": "2016-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "836855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.