Socorro Maria Gomez, LICENSED MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 45862 Issued in CA

Practice address

17216 Slover Ave BLDG L
Fontana, CA 92337-7580

Phone

(909) 854-3420

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Socorro Maria Gomez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1396882874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 AZURE CT",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866408",
            "telephone_number": "909-210-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17216 SLOVER AVE BLDG L",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377580",
            "telephone_number": "909-854-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "SOCORRO",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LICENSED MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 45862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOCORRO",
            "last_name": "GOMEZ",
            "middle_name": "MARIA",
            "prefix": "MS.",
            "credential": "MFC 45862",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Todd Goldenberg, MD
• Goldstar Pediatrics PC
• Alonzo Gomez, RRT, RPSGT
• Christina Renee Gomez
• Jonathan Vinicio Gomez
• Ampora Liana Gonzales
• Anthony Guadalupe Gonzalez Verdin
• Nohemi Blanch Gonzalez Warner
• Jaquelinne Gonzalez-Ruiz
• Adriana Gonzalez, DO

• Marriage & Family Therapist in Fontana, CA
• Providers in Fontana, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.