Provider Demographics
NPI:1760342026
Name:RODRIGUEZ GOMEZ, CLAUDIA (PPS)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:RODRIGUEZ GOMEZ
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:ARACELI
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17071 GOTHARD ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17071 GOTHARD ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5417
Practice Address - Country:US
Practice Address - Phone:714-292-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220109994103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty