Individual ProviderDanielle Jannette GomezCase Manager/Care CoordinatorOther Service ProvidersPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610(505) 268-5295PECOS EnrollmentBased on the most recent information from CMS, provider Danielle Jannette Gomez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1952682924Provider TypeIndividualFull NameGomez, Danielle JannetteTitleMrs.GenderFemaleSole ProprietorNoEnumeration Date9/6/2011Last Updated9/6/2011Contact InformationPractice LocationPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxMailing LocationMailing Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDB9311DescriptionMedicaidIssuerUnlistedNew Mexico