Active NPI
Evelyn Gomez
- Speech-Language Pathologist
- Dublin, CA
National Provider Identifier
1730545666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 32129
- Practice address
- 9801 Dublin Blvd
Dublin, CA 94568-2835 - Phone
- (925) 829-9555
- NPI assigned
- Jan 7, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | E2998161 | CA | |
| Speech-Language Pathologist | 235Z00000X | 32129 | CA | Primary |
Addresses
Primary practice location
9801 Dublin Blvd
Dublin, CA 94568-2835
Mailing address
305 Brookside Dr
Antioch, CA 94509-6109
Phone (510) 307-9848
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 |
|---|---|---|---|
| E2998161 | CA | MD | Behavioral Analyst |
| 32129 | CA | MD | Dental Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| School of Imagination | Behavior Analyst | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1730545666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 BROOKSIDE DR",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945096109",
"telephone_number": "510-307-9848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9801 DUBLIN BLVD",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682835",
"telephone_number": "925-829-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "EVELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-07",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "E2998161",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "32129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.