Individual
LISSETTE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
617 BAYONET CIR, MARINA, CA 93933-4600
(831) 384-7251
Mailing address
617 BAYONET CIR, MARINA, CA 93933-4600
(831) 384-7251
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
11/13/2019
Last updated
11/04/2025
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