Provider Demographics
NPI:1518015007
Name:URRUTIA, MARIA C
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:C
Last Name:URRUTIA
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 1:4916 E TULARE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-3069
Mailing Address - Country:US
Mailing Address - Phone:559-251-6681
Mailing Address - Fax:
Practice Address - Street 1:205 N BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1914
Practice Address - Country:US
Practice Address - Phone:559-498-0241
Practice Address - Fax:559-498-6220
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner