Patricia Miriam Gomez-Gillard, LICENSED CLINICAL SO

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW28005 Issued in CA

Practice address

1926 Scenic Drive
Fortuna, CA 95540

Phone

(707) 273-8701

NPI assigned

May 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Patty Miriam Gomez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1891055703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3608",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955023608",
            "telephone_number": "707-273-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 SCENIC DRIVE",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "95540",
            "telephone_number": "707-273-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-GILLARD",
        "first_name": "PATRICIA",
        "middle_name": "MIRIAM",
        "credential": "LICENSED CLINICAL SO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCS28005",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW28005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATTY",
            "last_name": "GOMEZ",
            "middle_name": "MIRIAM",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joyme Balan Gesite
• Chris Ghadimi, OTD, OTR/L, CNS
• Lexis D Gillette
• Kenneth Glenn, DDS
• D. Peter Goldberg, M.D.
• Rodney Blaine Grover, DO
• Jack L Guccione, M.D., MPH
• Healing Roots Curando Raices LLC
• Healing Roots Curando Raices PC
• Dylan Heard

• Mental Health Counselor in Fortuna, CA
• Providers in Fortuna, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.