GINA MARIE GOMEZ-LAZZARA (NPI# 1417584483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417584483 |
| Entity Type | Individual |
| Full Name | GINA MARIE GOMEZ-LAZZARA |
| Credential | RADT1 |
| Practice Address |
125 W F St Ontario CA 91762-3201 |
| Mailing Address |
5974 Boone Ct Riverside CA 92506-1721 |
| Practice Telephone | 9099864550 |
| Practice Fax Number | 9099864506 |
| Mailing Telephone | 7149323300 |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
R1379750320 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5974 Boone Ct, Riverside, CA 925061721 | 7149323300 |
| Street Address |
125 W F ST |
| City | ONTARIO |
| State | CA |
| Zip Code | 91762-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275698615 | Aegis Treatment Centers, LLC | Clinic/Center | 125 W F St, Ontario, CA 91762-3201 | 2006-12-26 |
| 1841800331 | Benedette Threet | Counselor | 125 W F St, Ontario, CA 91762-3201 | 2020-08-09 |
| 1952911570 | Jessica Cobian Medina | Counselor | 125 W F St, Ontario, CA 91762-3201 | 2020-08-07 |
| 1639706385 | Patricia Joanne Williams | Counselor | 125 W F St, Ontario, CA 91762-3201 | 2020-03-24 |
| 1801438833 | Bryan Steve Garcia | Counselor | 125 W F St, Ontario, CA 91762 | 2019-10-10 |
| 1285280776 | Jabari Boyd | Counselor | 125 W F St, Ontario, CA 91762-3201 | 2019-08-12 |
| 1831743913 | Nakia Petty Boone | Licensed Vocational Nurse | 125 W F St, Ontario, CA 91762-3201 | 2019-07-28 |
| 1871158402 | Margarita Lauretta Camarena | Licensed Vocational Nurse | 125 W F St, Ontario, CA 91762-3201 | 2019-05-09 |
| 1770146599 | Hector Chavez-arce | Licensed Vocational Nurse | 125 W F St, Ontario, CA 91762-3201 | 2019-04-17 |
| 1922661743 | Chenay Quiros | Licensed Vocational Nurse | 125 W F St, Ontario, CA 91762-3201 | 2019-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093486 | Samantha Jo Brumfield | Nurse Practitioner | 5562 Central Avenue, Suite 300, Chino, CA 91762 | 2019-09-20 |
| 1215598578 | Janet Murphy | Behavior Technician | 1520 North Mountain Ave., Ste 206, Ontario, CA 91762 | 2019-06-26 |
| 1437717550 | Fjs Hearing Professionals | Hearing Instrument Specialist | 528 N Palm Ave, Ontario, CA 91762 | 2019-06-04 |
| 1669990768 | Claudia Juarez Tapia | Counselor | 125 W F Street, Ontario, CA 91762 | 2017-09-08 |
| 1093230468 | David Rayo | Respiratory Therapist, Registered | 805 W E St, Ontario, CA 91762 | 2017-08-07 |
| 1215475348 | Chinmay Patel | Physical Therapist | 910 S Mountain Avenue Unite A, Ontario, CA 91762 | 2017-02-09 |
| 1003265604 | Bambi Mpiana | Dentist | 1337 N Mountain Ave Ste 1, Ontario, CA 91762 | 2016-06-06 |
| 1548630940 | Ned Paniagua, Dmd A Professional Corporation | Dentist | 533 W. Holt Blvd., Suite B, Ontario, CA 91762 | 2015-09-29 |
| 1568865251 | Jennifer Estberg | Student in an Organized Health Care Education/Training Program | 317 W. F Street, Ontario, CA 91762 | 2014-10-08 |
| 1447660873 | Agha Zulfequar Hayder | Nurse Practitioner | 1001 West 6th Street, Suite B., Ontario, CA 91762 | 2014-05-07 |
| Find all providers in zip 91762 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669990768 | Claudia Juarez Tapia | Counselor | 125 W F Street, Ontario, CA 91762 | 2017-09-08 |
| 1417489949 | Kristopher Reyes | Counselor | 125 W F St Unit 101, Ontario, CA 91762-3201 | 2017-04-03 |
| 1326399510 | Kevin V Chandler | Counselor | 1921 E Banyan St, Ontario, CA 91761-6405 | 2012-09-27 |
| 1376772673 | Elizabeth Diane Roberts | Counselor | 747 N. Euclid Ave, Ontario, CA 91762-2878 | 2009-07-08 |
| 1154576650 | Krystle Lasha Greely | Counselor | 1801 Excise Ave Ste 116, Ontario, CA 91761 | 2008-11-25 |
| 1962655456 | Quan L Hancock | Counselor | 125 W F St Ste 101, Ontario, CA 91762-3262 | 2008-10-28 |
| 1144432162 | Rena Cantu | Counselor | 316 East E Street, Ontario, CA 91764 | 2007-05-03 |
| 1184842122 | Rosemary Yates | Counselor | 125 West F St, Ontario, CA 91762 | 2007-04-23 |
| 1457486573 | Gilford C Hoel | Counselor | 30503 Opus Rd, Ontario, WI 54651-6537 | 2007-02-22 |
| 1871636233 | Norman Croom | Counselor | 1647 Holt Blvd, Ontario, CA 91761-2107 | 2007-02-15 |
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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.