Provider Demographics
NPI:1356800403
Name:KAUFMAN-GOMEZ, CATHERINE LYNNE (LCSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LYNNE
Last Name:KAUFMAN-GOMEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:LYNNE
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:10301 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2040
Mailing Address - Country:US
Mailing Address - Phone:408-252-3000
Mailing Address - Fax:
Practice Address - Street 1:1309 S MARY AVE STE 250
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3054
Practice Address - Country:US
Practice Address - Phone:408-252-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA280031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical