Active NPI
Mariah R. Gomez-Falcon, PH.D.
- Clinical Psychologist
- Burbank, CA
National Provider Identifier
1922245174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY14147
- Practice address
- 905 South Lake Street
Suite 201
Burbank, CA 91502 - Phone
- (818) 848-5653
- NPI assigned
- Jan 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY14147 | CA | Primary |
| Clinical Psychologist | 103TC0700X | 0005280 | FL |
Addresses
Primary practice location
905 South Lake Street
Suite 201
Burbank, CA 91502
Mailing address
905 South Lake Street
Suite 201
Burbank, CA 91502
Phone (818) 848-5653
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY14147 | CA | MD | Clinical Psychologist |
| 0005280 | FL | MD | Clinical Psychologist |
| 14147 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231459200000",
"number": "1922245174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 SOUTH LAKE STREET",
"address_2": "SUITE 201",
"city": "BURBANK",
"state": "CA",
"postal_code": "91502",
"telephone_number": "818-848-5653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 SOUTH LAKE STREET",
"address_2": "SUITE 201",
"city": "BURBANK",
"state": "CA",
"postal_code": "91502",
"telephone_number": "818-848-5653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ-FALCON",
"first_name": "MARIAH",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-09",
"last_updated": "2009-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY14147",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "0005280",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.