RAFAEL AMAYA GOMEZ NPI 1902115439

NPI Information

NPI: 1902115439
Provider Name: RAFAEL AMAYA GOMEZ
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
4660 VIEWRIDGE AVE STE 100A
SAN DIEGO, CA
ZIP 92123
Phone: (619) 937-1430
Get Directions

Rafael Amaya Gomez is an addiction (substance use disorder) counselor in San Diego, CA. Rafael Amaya Gomez NPI is 1902115439. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4660 VIEWRIDGE AVE STE 100A
SAN DIEGO, CA
ZIP 92123-638
Phone: (619) 937-1430

The enumeration date for this NPI number is 10/1/2010 and was last updated on 3/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	101YM0800X	Counselor	Mental Health			No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	112579III	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8544	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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