Individual provider Active NPI

Maricela Gomez

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1891169033
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC123206 Issued in CA
Practice address
550 W Alluvial Ave Ste 108
Fresno, CA 93711-5857
Phone
(559) 795-5990
NPI assigned
Nov 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PCCI2191 CA
Marriage & Family Therapist 106H00000X MFC12320 CA
Marriage & Family Therapist 106H00000X IMF87833 CA
Marriage & Family Therapist 106H00000X MFC123206 CA Primary

Addresses

Primary practice location

550 W Alluvial Ave Ste 108
Fresno, CA 93711-5857

Mailing address

6181 W Concordia Dr
Fresno, CA 93722-2666

Other practice location 1

209 E 7th St
Madera, CA 93638-3780
Phone (559) 673-3508

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

LicenseStateTypeSpecialty
PCCI2191CAMDProfessional Counselor
IMF87833CAMDMarriage & Family Therapist
MFC12320CAMDMarriage & Family Therapist
MFC123206CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno Family Therapy Marriage & Family Therapist CurrentSince Jul 25, 2021 Accepting new patients
California Couples and Marriage Counseling, Inc Marriage & Family Therapist CurrentSince Apr 14, 2024 Accepting new patients

Locations

550 W Alluvial Ave
Ste 108
Fresno, CA 93711
Phone (559) 761-9724

Organizations & group practices 2

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": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1891169033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6181 W CONCORDIA DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937222666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W ALLUVIAL AVE STE 108",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115857",
            "telephone_number": "559-795-5990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936383780",
            "country_code": "US",
            "telephone_number": "559-673-3508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "MARICELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-28",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "PCCI2191",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC12320",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF87833",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC123206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.