Provider Demographics
NPI:1639788532
Name:GOMEZ, ROLINDA SOLARIO
Entity Type:Individual
Prefix:
First Name:ROLINDA
Middle Name:SOLARIO
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 N 6TH ST STE 169
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7505
Mailing Address - Country:US
Mailing Address - Phone:559-474-3690
Mailing Address - Fax:559-353-2009
Practice Address - Street 1:5150 N 6TH ST STE 169
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7505
Practice Address - Country:US
Practice Address - Phone:559-978-4769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical