Provider Demographics
NPI:1467696229
Name:GOMEZ-HOTKO, ASHLEY RHIANNON (MA LMFT 95073)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RHIANNON
Last Name:GOMEZ-HOTKO
Suffix:
Gender:F
Credentials:MA LMFT 95073
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 QUARTET LOOP UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2708
Mailing Address - Country:US
Mailing Address - Phone:619-206-5919
Mailing Address - Fax:
Practice Address - Street 1:2004 QUARTET LOOP UNIT 1
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-2708
Practice Address - Country:US
Practice Address - Phone:619-329-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95073101YM0800X
101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty