Active NPI
Robert Gomez
- Behavior Analyst
- San Carlos, CA
National Provider Identifier
1811236508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 941186168
- Practice address
- 957 Industrial Rd Ste B
San Carlos, CA 94070-4152 - Phone
- (415) 375-7591
- Fax
- (650) 620-9549
- NPI assigned
- Jan 31, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 941186168 | CA | Primary |
Addresses
Primary practice location
957 Industrial Rd Ste B
San Carlos, CA 94070-4152
Mailing address
957 Industrial Rd Ste B
San Carlos, CA 94070-4152
Phone (415) 375-7591
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 |
|---|---|---|---|
| 941186168 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1811236508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "957 INDUSTRIAL RD STE B",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940704152",
"telephone_number": "415-375-7591",
"fax_number": "650-620-9549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "957 INDUSTRIAL RD STE B",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940704152",
"telephone_number": "415-375-7591",
"fax_number": "650-620-9549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-31",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "941186168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.