Provider Demographics
NPI:1154202604
Name:GOMEZ, OFELIA (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:OFELIA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SISK RD
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-9445
Mailing Address - Country:US
Mailing Address - Phone:209-545-0339
Mailing Address - Fax:
Practice Address - Street 1:4801 SISK RD
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CA
Practice Address - Zip Code:95368-9445
Practice Address - Country:US
Practice Address - Phone:209-545-0339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist