Provider Demographics
NPI:1639681893
Name:GOMEZ, YOLANDA PATRICIA (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:PATRICIA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1555 S GAREY AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-5222
Mailing Address - Country:US
Mailing Address - Phone:626-919-4333
Mailing Address - Fax:626-331-8526
Practice Address - Street 1:276 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1902
Practice Address - Country:US
Practice Address - Phone:626-919-4333
Practice Address - Fax:626-331-8526
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1133461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program