Provider Demographics
NPI:1235010307
Name:GOMITO, RYAN ALBATERA (PHD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ALBATERA
Last Name:GOMITO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4738 WILD DRAW DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2899
Mailing Address - Country:US
Mailing Address - Phone:702-485-5256
Mailing Address - Fax:
Practice Address - Street 1:4738 WILD DRAW DR
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2899
Practice Address - Country:US
Practice Address - Phone:702-485-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV208794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty