Provider Demographics
NPI:1033954995
Name:GAMEZ, BRIAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:GAMEZ
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 KROY WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-2048
Mailing Address - Country:US
Mailing Address - Phone:707-241-5775
Mailing Address - Fax:
Practice Address - Street 1:71 HUDDLESTONE CIR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2543
Practice Address - Country:US
Practice Address - Phone:916-235-3157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
34793235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist