Gomez, Evangelina

Gomez, Evangelina is an individual health care provider with primary practice located at 1400 Emeline Ave , Santa Cruz CA 95060-1976. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Gomez, Evangelina can be contacted via phone (831) 454-4170.

Contact Information

Primary practice address
1400 Emeline Ave Santa Cruz CA 95060-1976
Phone: (831) 454-4170
Fax: (831) 454-4663
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CADC G0605261426 California

Profile Details

NPI number 1023234291
LBN Legal business name Gomez, Evangelina
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2007
Last updated Mar 27th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023234291 NPPES
California Other ZZZ91892Z SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#
California Other FHC70042F SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#
California Other FHC70044F SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#
California Other G0605261426 SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#
California Other ZZZ91891Z SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#
California Other ZZZ92069Z SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#

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