Provider Demographics
NPI:1497848733
Name:GOMEZ, CLAUDEA MANN (MS, MFT)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDEA
Middle Name:MANN
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 TELEGRAPH RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3705
Mailing Address - Country:US
Mailing Address - Phone:805-658-2709
Mailing Address - Fax:805-658-2709
Practice Address - Street 1:4243 TELEGRAPH RD
Practice Address - Street 2:SUITE #3
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3705
Practice Address - Country:US
Practice Address - Phone:805-658-2709
Practice Address - Fax:805-658-2709
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42484106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist