Provider Demographics
NPI:1891814901
Name:GOMEZ, GLORIA JEAN II
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:JEAN
Last Name:GOMEZ
Suffix:II
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 1:11429 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3229
Mailing Address - Country:US
Mailing Address - Phone:626-442-8391
Mailing Address - Fax:626-442-8387
Practice Address - Street 1:11429 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3229
Practice Address - Country:US
Practice Address - Phone:626-442-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist