Provider Demographics
NPI:1366037129
Name:GOMEZ-MARTINEZ, ADRIANA (MED)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:GOMEZ-MARTINEZ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1032 W 225TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2312
Mailing Address - Country:US
Mailing Address - Phone:310-702-0258
Mailing Address - Fax:
Practice Address - Street 1:1063 MCGAW AVE STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5554
Practice Address - Country:US
Practice Address - Phone:714-876-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst