Provider Demographics
NPI:1740447499
Name:GOMEZ-RAMOS, JOSE ANTONIO (MA, MFT, LADC, NCAC)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ANTONIO
Last Name:GOMEZ-RAMOS
Suffix:
Gender:M
Credentials:MA, MFT, LADC, NCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 C ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4877
Mailing Address - Country:US
Mailing Address - Phone:775-359-8136
Mailing Address - Fax:775-359-3632
Practice Address - Street 1:1859 C ST
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4877
Practice Address - Country:US
Practice Address - Phone:775-359-8136
Practice Address - Fax:775-359-3632
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV522-L101YA0400X
NV0925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)