Provider Demographics
NPI:1962221192
Name:GOMEZ-RESENDIZ, DEBORAH (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:GOMEZ-RESENDIZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E. MCDOWELL ROAD
Mailing Address - Street 2:TOWER 1, 9TH FLOOR
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2612
Mailing Address - Country:US
Mailing Address - Phone:602-839-9650
Mailing Address - Fax:
Practice Address - Street 1:1111 E. MCDOWELL ROAD
Practice Address - Street 2:TOWER 1, 9TH FLOOR
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:602-839-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ314741363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health