Most Relevant Information
Provider Data
| NPI Number: | 1003548520 |
| Provider Name: | MADISON ALEXA GOMEZ LMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 133389 |
Most Important Dates
| Enumeration Date: | 06/24/2022 |
| Last Updated: | 06/29/2022 |
Provider Practice Location
1098 MELODY LN STE 101
ROSEVILLE
CA
956785138
Practice Location Phone/Fax
| Phone: | 9168843812 |
| Fax: |
Provider Mailing Location
PO BOX 2417
MARYSVILLE
CA
959010086
Provider Mailing Phone/Fax
| Phone: | 5303000264 |
| Fax: |