Provider Demographics
NPI:1396545927
Name:GOMEZ, ALEXANDRA-GRISSELL
Entity type:Individual
Prefix:
First Name:ALEXANDRA-GRISSELL
Middle Name:
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 1:22410 VIOLETA AVE
Mailing Address - Street 2:
Mailing Address - City:HAWAIIAN GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90716-1342
Mailing Address - Country:US
Mailing Address - Phone:562-445-7331
Mailing Address - Fax:
Practice Address - Street 1:22410 VIOLETA AVE
Practice Address - Street 2:
Practice Address - City:HAWAIIAN GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90716-1342
Practice Address - Country:US
Practice Address - Phone:562-445-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula