TIM GOMERSALL (NPI# 1114285772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114285772 |
| Entity Type | Individual |
| Full Name | TIM GOMERSALL |
| Credential | L.E.P. |
| Practice Address |
525 2nd St Eureka CA 95501-5107 |
| Mailing Address |
Po Box 6131 Eureka CA 95502-6131 |
| Practice Telephone | 7074077475 |
| Practice Fax Number | 7074411913 |
| Mailing Telephone | 7074077475 |
| Mailing Fax Number | 7074411913 |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
LEP 2754 | CA | Behavioral Health & Social Service Providers |
| Street Address |
525 2ND ST |
| City | EUREKA |
| State | CA |
| Zip Code | 95501-5107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487650321 | Anne S Carlisle | Nurse Practitioner | 525 2nd St, Suite 219, Eureka, CA 95501-5107 | 2005-06-24 |
| 1619188315 | Ange J Lobue | Psychiatry & Neurology | 525 2nd St, Suite 300, Eureka, CA 95501-0437 | 2007-05-24 |
| 1124107081 | John James Sullivan | Pediatrics | 525 2nd St, #300, Eureka, CA 95501-5107 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538795919 | Eric Meyer Goldsmith | Physical Therapist | 2306 Dean Street, Eureka, CA 95501 | 2020-03-18 |
| 1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
| 1740831767 | Jacqueline Renee Coghill | Nurse Practitioner | Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501 | 2019-09-20 |
| 1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
| 1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
| 1730698283 | Gabriel Holtski | Naturopath | 1632 Broadway, Suite #252, Eureka, CA 95501 | 2017-09-27 |
| 1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
| 1033651922 | Narum Clinical Services | Social Worker | 930 3rd St, Suite 201, Eureka, CA 95501 | 2016-11-09 |
| 1750839510 | Sierra Marie Evers-hellmich | Physical Medicine & Rehabilitation | 2103 Myrtle Avenue, Eureka, CA 95501 | 2016-09-21 |
| 1558720623 | Jennifer Vu | Behavioral Analyst | 730 7th St Ste A, Eureka, CA 95501 | 2016-02-18 |
| Find all providers in zip 95501 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730705526 | Claire Ajina | Psychologist | 3009 Hubbard Ln Ste F, Eureka, CA 95501-4801 | 2020-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800610 | Christine Irene Wyeth I | Psychologist | 420 Orrell Dr, National City, CA 91950-7019 | 2020-10-30 |
| 1396351755 | Darinisha Williams | Psychologist | 228 W Pomona Ave Unit 453, Monrovia, CA 91016-4853 | 2020-09-21 |
| 1861006280 | Waneka Cabrera | Psychologist | 6140 Monterey Rd Apt 419, Los Angeles, CA 90042-5410 | 2020-09-02 |
| 1447862669 | Lynn Syrvart Saroyan | Psychologist | 302 W 5th St Ste 301, San Pedro, CA 90731-2750 | 2020-08-19 |
| 1386256741 | Earaj Afzal | Psychologist | 4175 Williwaw Dr, Irvine, CA 92620-3279 | 2020-08-18 |
| 1518578145 | Christina Marie Keefe | Psychologist | 222 Terrace Dr, Big Pine, CA 93513-2002 | 2020-08-17 |
| 1992317572 | Ferris Kevin Bruton | Psychologist | 850 Rosewood Ave, Vallejo, CA 94591-5647 | 2020-08-17 |
| 1376153460 | Louis Scott Addleson | Psychologist | 7915 Alida St, La Mesa, CA 91942-2541 | 2020-08-04 |
| 1326658592 | Aamna Hassan | Psychologist | 15132 Amso St, Poway, CA 92064-2604 | 2020-08-03 |
| 1922616218 | Janis Kingsley | Psychologist | 2746 Granville Ave, Los Angeles, CA 90064-3604 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.