Individual
MR. JUAN GABRIEL GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
5701 W TALAVI BLVD STE 180, GLENDALE, AZ 85306-1888
(480) 335-8010
Mailing address
9219 W LOUISE DR, PEORIA, AZ 85383-3542
(480) 335-8010
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP10242
AZ
Other
Enumeration date
05/11/2017
Last updated
08/08/2022
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