| Doctor Name: | MATEO J GOMEZ |
| NPI Number: | 1053738088 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | IMF79930 |
| Business Practice Address: | 11731 Telegraph Rd Santa Fe Springs, CA - 906703675 |
| Business Phone Number: | 5629498455 |
| Business Fax Number: | |
| Mailing Address: | 1800 W Gramercy Ave, Unit 8 ANAHEIM |
| State: | CA |
| Postal Code: | 928014568 |
| Phone Number: | 4045424605 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2014 |
| NPI Last Update Date: | 05/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMF79930 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |