Most Relevant Information
Provider Data
| NPI Number: | 1003651134 |
| Provider Name: | GENESIS LEONOR GOMEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/29/2024 |
| Last Updated: | 06/29/2024 |
Provider Practice Location
1150 S KING RD # 152
SAN JOSE
CA
951222139
Practice Location Phone/Fax
| Phone: | 4086229222 |
| Fax: |
Provider Mailing Location
1135 HARRISON ST APT 6
SANTA CLARA
CA
950504252
Provider Mailing Phone/Fax
| Phone: | 6572489051 |
| Fax: |