Individual
MINDY GOMEZ DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 LLEWELLYN AVE, CAMPBELL, CA 95008
(408) 891-7861
Mailing address
251 LLEWELLYN AVE, CAMPBELL, CA 95008-1940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
11551
CA
171M00000X
Case Manager/Care Coordinator
D8897632
CA
Other
Enumeration date
06/02/2016
Last updated
06/09/2022
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