Provider Demographics
NPI:1649067182
Name:GOMEZ, RUTH ESMERALDA
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ESMERALDA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 WIND RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7576
Mailing Address - Country:US
Mailing Address - Phone:702-816-6026
Mailing Address - Fax:
Practice Address - Street 1:317 WIND RIVER DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7576
Practice Address - Country:US
Practice Address - Phone:702-816-6026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCHW1-6069172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker