Provider Demographics
NPI:1225705742
Name:GUTIERREZ, CATHERINE CELIA
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CELIA
Last Name:GUTIERREZ
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 1:3530 SCHOONER WALK
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-1643
Mailing Address - Country:US
Mailing Address - Phone:805-760-4289
Mailing Address - Fax:
Practice Address - Street 1:3530 SCHOONER WALK
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-1643
Practice Address - Country:US
Practice Address - Phone:805-760-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY8393796390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program