Provider Demographics
NPI:1376395475
Name:GOMEZ, DELFINA BRIDGETTE (AMFT)
Entity Type:Individual
Prefix:
First Name:DELFINA
Middle Name:BRIDGETTE
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4184 ALCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-3816
Mailing Address - Country:US
Mailing Address - Phone:619-981-3503
Mailing Address - Fax:
Practice Address - Street 1:4184 ALCORN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-3816
Practice Address - Country:US
Practice Address - Phone:619-981-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT136791106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty