Individual
BANNIA BIANNEY GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44738 10TH ST W, LANCASTER, CA 93534-3016
(661) 977-6644
Mailing address
PO BOX 611, LANCASTER, CA 93584-0611
(626) 494-0744
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/07/2013
Last updated
08/29/2022
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