Active NPI
Rodrigo Gomez
- Licensed Psychiatric Technician
- Rosemead, CA
National Provider Identifier
1922321843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- Practice address
- 4619 Rosemead Blvd
Rosemead, CA 91770-1478 - Phone
- (626) 286-1191
- NPI assigned
- Mar 5, 2010
- Last updated
- Sep 19, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | CA | Primary | |
| Rehabilitation Practitioner | 225400000X | NU |
Addresses
Primary practice location
4619 Rosemead Blvd
Rosemead, CA 91770-1478
Mailing address
4122 Lincoln Ave
El Monte, CA 91731-2108
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568851200000",
"number": "1922321843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4122 LINCOLN AVE",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917312108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4619 ROSEMEAD BLVD",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917701478",
"telephone_number": "626-286-1191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "RODRIGO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-05",
"last_updated": "2019-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosemead, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.