MR. MARCO ANTONIO GOMEZ (NPI# 1790234466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790234466 |
| Entity Type | Individual |
| Full Name | MR. MARCO ANTONIO GOMEZ |
| Practice Address |
3075 Adeline St Suite 120 Berkeley CA 94703-2576 |
| Practice Telephone | 5108481112 |
| Mailing Telephone | 5108481112 |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235556085 | Marco Antonio Gomez | Physician Assistant | 210 S. Bryan Rd. Ste, Suite 1, Mission, TX 78572-6208 | 2014-03-18 |
| 1811171572 | Marco A Gomez | Family Medicine | 2356 Meadows Blvd Ste 140b, Castle Rock, CO 80109-8410 | 2007-12-18 |
| 1780874743 | Marco Gomez | Counselor | 1319 Fruitvale Ave, Oakland, CA 94601-2927 | 2007-07-26 |
| Street Address |
3075 ADELINE ST SUITE 120 |
| City | BERKELEY |
| State | CA |
| Zip Code | 94703-2576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730211368 | Linda K. Frankel | Psychiatry & Neurology | 3075 Adeline St, Suite 280, Berkeley, CA 94703-2576 | 2007-03-09 |
| 1972021095 | Gabriella Rochelle Ruzin | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Berkeley, CA 94703-2576 | 2017-09-08 |
| 1568996106 | Robin Ann Weber | Social Worker | 3075 Adeline St, 120, Berkeley, CA 94703-2576 | 2017-04-19 |
| 1326590688 | Alysha Swaim Aziz | Registered Nurse | 3075 Adeline St, St #280, Berkeley, CA 94703-2576 | 2016-11-02 |
| 1679944169 | Melanie Marusczak | Nurse Practitioner | 3075 Adeline St, Ste 280, Berkeley, CA 94703-2576 | 2015-10-09 |
| 1376911123 | Theresia Anderson | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Ste 120, Berkeley, CA 94703-2576 | 2015-09-10 |
| 1659749422 | Lori Lee | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2015-09-09 |
| 1316372501 | Kaeonadda Mindy Jitmanowan | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2013-09-06 |
| 1144655614 | Kuldip Raju | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Suite 120, Berkeley, CA 94703-2576 | 2013-09-03 |
| 1841623196 | Ashley Boyer | Student in an Organized Health Care Education/Training Program | 3075 Adeline St, Ste 120, Berkeley, CA 94703-2576 | 2013-08-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553621 | Brittney Jerrilena Monique Garrett | Behavioral Analyst | 1901 Stuart St, Berkeley, CA 94703 | 2019-05-16 |
| 1740762178 | Maryam Jabbari Amiri | Student in an Organized Health Care Education/Training Program | 3075 Adeline Street, Suite 120, Berkeley, CA 94703 | 2018-09-01 |
| 1619427549 | Sigal Gafni | Occupational Therapist | 1622 Parker St. Apt. 1, Berkeley, CA 94703 | 2016-10-04 |
| 1750741138 | Ane Becker | Community Health Worker | 2026 Woolsey St, Berkeley, CA 94703 | 2016-02-29 |
| 1245697135 | Sara Dinome Teel Vargas | Chiropractor | 3286 Adeline St., Suite 9, Berkeley, CA 94703 | 2016-01-22 |
| 1083081608 | Olivia Debree | Nurse Practitioner | 3075 Adeline Street, Suite 280, Lifelong Medical Care, Ashby Health Center, Berkeley, CA 94703 | 2015-08-31 |
| 1962885988 | Caro Grosvenor | Marriage & Family Therapist | 1511 Ada Street, Berkeley, CA 94703 | 2015-07-08 |
| 1619378452 | Myles Malone | Counselor | 2413 Jefferson Ave., Berkeley, CA 94703 | 2014-09-11 |
| 1013340223 | Denise Daniel | Acupuncturist | 6222 La Salle Ave Suite B, Oakland, CA 94703 | 2013-08-12 |
| 1104126200 | Iramis Kouromenos | Dental Hygienist | 1721 University Ave Apt#209, Berkeley, CA 94703 | 2010-10-25 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905814 | Adriana Costa | Student in an Organized Health Care Education/Training Program | 1936 Berryman St Apt B, Berkeley, CA 94709-1911 | 2020-09-06 |
| 1548871437 | Naomi Mae Wright | Student in an Organized Health Care Education/Training Program | 2461 Warring St Apt 211, Berkeley, CA 94704-2561 | 2020-08-13 |
| 1588291306 | Jake Loitz | Student in an Organized Health Care Education/Training Program | 1822 Francisco St Apt 22, Berkeley, CA 94703-1352 | 2020-03-23 |
| 1508417452 | Yvette Rico | Student in an Organized Health Care Education/Training Program | 1010 Grayson St Ste 3, Berkeley, CA 94710-2611 | 2019-09-23 |
| 1700443942 | Heather Marie Schrag | Student in an Organized Health Care Education/Training Program | 2712 Telegraph Ave # 94705, Berkeley, CA 94705-1117 | 2019-05-23 |
| 1720644388 | Shafai Marriam Zarabi | Student in an Organized Health Care Education/Training Program | 1940 Parker St, Berkeley, CA 94704-3207 | 2019-05-18 |
| 1780152876 | Isabel Unanue | Student in an Organized Health Care Education/Training Program | 1936 University Ave, Berkeley, CA 94704-1054 | 2018-11-06 |
| 1669957684 | Elizabeth Blieden | Student in an Organized Health Care Education/Training Program | 2712 Telegraph Ave # B, Berkeley, CA 94705-1117 | 2018-09-25 |
| 1740762178 | Maryam Jabbari Amiri | Student in an Organized Health Care Education/Training Program | 3075 Adeline Street, Suite 120, Berkeley, CA 94703 | 2018-09-01 |
| 1972080158 | Cecilia Winfield | Student in an Organized Health Care Education/Training Program | 1918 University Ave., Suite 2b, Berkeley, CA 94704 | 2018-07-20 |
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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.