Provider Demographics
NPI:1659872729
Name:GOMEZ, CHRISTA (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:333 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6540
Mailing Address - Country:US
Mailing Address - Phone:855-832-6727
Mailing Address - Fax:772-675-9100
Practice Address - Street 1:7000 FRANKLIN BLVD STE 520
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-55138103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst