Individual provider Active NPI

Diana C Gomez

  • Community/Behavioral Health Agency
  • Belmont, CA
National Provider Identifier
1558617597
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
400 Harbor Blvd
Suite E
Belmont, CA 94002-4047
Phone
(650) 802-6414
Fax
(650) 802-6440
NPI assigned
Jul 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

400 Harbor Blvd
Suite E
Belmont, CA 94002-4047

Mailing address

400 Harbor Blvd
Suite E
Belmont, CA 94002-4047
Phone (650) 802-6414

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

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1558617597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HARBOR BLVD",
            "address_2": "SUITE E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024047",
            "telephone_number": "650-802-6414",
            "fax_number": "650-802-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARBOR BLVD",
            "address_2": "SUITE E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024047",
            "telephone_number": "650-802-6414",
            "fax_number": "650-802-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "DIANA",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.