RAFAEL AMAYA GOMEZ - NPI 1902115439 - Counselor in San Diego, CA

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

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About Rafael Amaya Gomez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAFAEL AMAYA GOMEZ (NPI 1902115439) is an individual addiction (substance use disorder) provider in San Diego, California, licensed in California (112579III) and active in the NPI registry since October 2010.

NPPES Registry Identity

NPI1902115439

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameRAFAEL AMAYA GOMEZ

Location Address4660 VIEWRIDGE AVE STE 100ASan Diego, CA 92123-1638

Mailing Address4660 Viewridge Ave Ste 100aSan Diego, CA 92123-1638 · (619) 937-1430

Phone(619) 937-1430

Sole ProprietorNo

Enumeration DateOctober 1, 2010

Last NPPES UpdateMarch 15, 2022

NPPES CertifiedMarch 15, 2022

✔ NPI 1902115439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in CA · 112579III

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

4660 VIEWRIDGE AVE STE 100A, San Diego, CA 92123

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Other Names 1

Other Name (5)Rafael Amaya Ortiz-gomez Coadc

Other Identifiers 1

Medicaid8544CA

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVA BERNADETTE ESCOBEDO EVA

Counselor (Addiction (Substance Use Disorder))