Provider Demographics
NPI:1538549688
Name:GOMEZ, MARGARITA LUCIA (MS, OTR/L, RPF-I)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:LUCIA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MS, OTR/L, RPF-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2271 SHIBLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-4066
Mailing Address - Country:US
Mailing Address - Phone:408-472-0993
Mailing Address - Fax:
Practice Address - Street 1:2271 SHIBLEY AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-4066
Practice Address - Country:US
Practice Address - Phone:408-472-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 806225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics