Active NPI
Nicholas Raymond Gomez
- Behavior Technician
- Pasadena, CA
National Provider Identifier
1992201669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-115416
- Practice address
- 177 E Colorado Blvd Ste 2082
Pasadena, CA 91105-1986 - Phone
- (844) 669-7827
- NPI assigned
- Apr 2, 2018
- 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 Technician | 106S00000X | RBT-20-115416 | CA | Primary |
Addresses
Primary practice location
177 E Colorado Blvd Ste 2082
Pasadena, CA 91105-1986
Mailing address
4067 W 3Rd St Apt 404
Los Angeles, CA 90020-5900
Phone (626) 221-0477
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 |
|---|---|---|---|
| RBT-20-115416 | CA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1992201669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4067 W 3RD ST APT 404",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900205900",
"telephone_number": "626-221-0477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 E COLORADO BLVD STE 2082",
"city": "PASADENA",
"state": "CA",
"postal_code": "911051986",
"telephone_number": "844-669-7827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "NICHOLAS",
"middle_name": "RAYMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-02",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-20-115416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.