Active NPI
Jessica Gomez
- Rehabilitation Practitioner
- Artesia, CA
National Provider Identifier
1386928059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 18432 Gridley Rd
Artesia, CA 90701-5404 - Phone
- (562) 860-2479
- Fax
- (562) 860-7109
- NPI assigned
- Sep 29, 2011
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
18432 Gridley Rd
Artesia, CA 90701-5404
Mailing address
1355 Vine St
San Bernardino, CA 92411-2640
Phone (562) 860-2479
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clontarf Manor Inc. | Past | Accepting new patients | |
| Clontarf Manor, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Assisted Living Facility
- Artesia, CA
- NPI 1598478745
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Artesia, CA
- NPI 1588791446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1386928059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 VINE ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924112640",
"telephone_number": "562-860-2479",
"fax_number": "562-860-7109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18432 GRIDLEY RD",
"city": "ARTESIA",
"state": "CA",
"postal_code": "907015404",
"telephone_number": "562-860-2479",
"fax_number": "562-860-7109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "JESSICA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-29",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Artesia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.