Active NPI
Gabriela Gomes Costardi, DO
- Psychologist
- Ontario, CA
National Provider Identifier
1609380930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSB94022736
- Practice address
- 1011 N Begonia Ave
Ontario, CA 91762-2104 - Phone
- (800) 683-2945
- NPI assigned
- Nov 22, 2017
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSB94022736 | CA | Primary |
Addresses
Primary practice location
1011 N Begonia Ave
Ontario, CA 91762-2104
Mailing address
488 W Duarte Rd Apt 7
Arcadia, CA 91007-6839
Phone (818) 913-5874
Other names 1
- Gabriela Gomes
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSB94022736 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511308800000",
"number": "1609380930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "488 W DUARTE RD APT 7",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910076839",
"telephone_number": "818-913-5874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 N BEGONIA AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917622104",
"telephone_number": "800-683-2945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMES COSTARDI",
"first_name": "GABRIELA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-22",
"last_updated": "2017-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSB94022736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GABRIELA",
"last_name": "GOMES",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.