Provider Demographics
NPI:1235465220
Name:GUTIERREZ, DEBORAH
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:OLEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:646 N H ST
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-4519
Mailing Address - Country:US
Mailing Address - Phone:805-865-1940
Mailing Address - Fax:805-865-1954
Practice Address - Street 1:646 N H ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-4519
Practice Address - Country:US
Practice Address - Phone:805-865-1940
Practice Address - Fax:805-865-1954
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health