MR. DOMINGO GOMEZ JR. (NPI# 1164597753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164597753 |
| Entity Type | Individual |
| Full Name | MR. DOMINGO GOMEZ JR. |
| Practice Address |
290 Ioof Ave Gilroy CA 95020-5204 |
| Practice Telephone | 4088462100 |
| Mailing Telephone | 4088462100 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2018-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | UNICARE # | 41321 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023040243 | Domingo Gomez | Family Medicine | 415 W 49th St Ste 1, Hialeah, FL 33012-3637 | 2006-07-07 |
| Street Address |
290 IOOF AVE |
| City | GILROY |
| State | CA |
| Zip Code | 95020-5204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132268 | Patricia Del Carmen Amaya | Licensed Vocational Nurse | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-10-20 |
| 1427655505 | Alyse Freitas | Counselor | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-10-02 |
| 1295342632 | Shalane Lee | Counselor | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-09-29 |
| 1942816814 | Rachel Marie Anderson | Case Manager/Care Coordinator | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-09-16 |
| 1689288052 | Alexis Acevedo | Counselor | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-09-03 |
| 1508470089 | Kathryn Elizabeth Wampler | Counselor | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-09-02 |
| 1023622719 | Justin Janda | Counselor | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-09-01 |
| 1609487602 | Justin Azevedo | Marriage & Family Therapist | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-08-12 |
| 1740890995 | Andrea Natali Lopez | Technician | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-08-03 |
| 1992314348 | Samantha Kathleen Chicca | Student in an Organized Health Care Education/Training Program | 290 Ioof Ave, Gilroy, CA 95020-5204 | 2020-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376158105 | Benjamin Liupaogo | Case Manager/Care Coordinator | Rebekah Children's Services, 290 Ioof Ave, Gilroy, CA 95020 | 2020-09-09 |
| 1205457330 | Ethel Rostran | Counselor | 290 I00f Ave., Gilroy, CA 95020 | 2020-04-29 |
| 1407498868 | Mehak Saini | Behavior Technician | 9360 Noname Uno, Gilroy, CA 95020 | 2019-10-16 |
| 1629622899 | Bruce Daniel Pirl | Counselor | 290 Ioof Rebekah Children Ave, 290 Ioof Avenue-phoenix School, Gilroy, CA 95020 | 2019-07-26 |
| 1932752490 | Eamon F. Burke | Counselor | Rebekah Children Services, 290 Ioof Ave., Gilroy, CA 95020 | 2019-07-23 |
| 1578116232 | Jose Enrique Cruz | Behavior Technician | 9360 Noname Uno #130, Gilroy, CA 95020 | 2019-07-22 |
| 1558925560 | Mauricio Hazael Procopio | Behavioral Analyst | 9360 Noname Uno Suite 130, Gilroy, CA 95020 | 2019-04-24 |
| 1689138893 | Gabriela Mendoza | Behavioral Analyst | 9395 Kern Ave, Gilroy, CA 95020 | 2019-01-22 |
| 1972082782 | Andrea Gloria Blanton | Social Worker | Rebekah Children's Services, 290 100f Ave, Gilroy, CA 95020 | 2018-08-13 |
| 1407334626 | Katrina Davina Aguilera | Case Manager/Care Coordinator | 290 Loof Ave., Gilroy, CA 95020 | 2018-07-31 |
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| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906572 | Connie Marie Contreras | Case Manager/Care Coordinator | 9410 Trailblazer Way, Gilroy, CA 95020-8105 | 2020-09-10 |
| 1376158105 | Benjamin Liupaogo | Case Manager/Care Coordinator | Rebekah Children's Services, 290 Ioof Ave, Gilroy, CA 95020 | 2020-09-09 |
| 1407334626 | Katrina Davina Aguilera | Case Manager/Care Coordinator | 290 Loof Ave., Gilroy, CA 95020 | 2018-07-31 |
| 1275032567 | Elvia Escalera | Case Manager/Care Coordinator | Rebekah Children's Services, 290 Ioof Ave., Gilroy, CA 95020 | 2018-02-02 |
| 1417473307 | Eileen Ortega | Case Manager/Care Coordinator | Rebekah Children's Services 290 Ioof Ave., Gilroy, CA 95020 | 2017-08-22 |
| 1588184162 | Michael Alan Gilbert Jr. | Case Manager/Care Coordinator | Rebekah Children's Services, 290 Ioof Ave, Gilroy, CA 95020 | 2017-06-23 |
| 1184144008 | Andrea Villalpando | Case Manager/Care Coordinator | 290 I.o.o.f. Ave., Gilroy, CA 95020 | 2017-06-21 |
| 1720519036 | Wanda Velez | Case Manager/Care Coordinator | 9015 Murray Ave # 100, Gilroy, CA 95020-3617 | 2017-03-27 |
| 1194275974 | Veronica Joanne Regalado | Case Manager/Care Coordinator | 290 Loof Ave, Gilroy, CA 95020 | 2016-10-05 |
| 1770942567 | Maribel Alcazar | Case Manager/Care Coordinator | 9035 Ridgeway Dr, Gilroy, CA 95020-7717 | 2016-02-22 |
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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.