Provider Demographics
NPI:1518670553
Name:VASQUEZ-GUTIERREZ, CHRISTINA ESPERANZA
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ESPERANZA
Last Name:VASQUEZ-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 1:1732 CANDLER LN
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8214
Mailing Address - Country:US
Mailing Address - Phone:209-606-0386
Mailing Address - Fax:
Practice Address - Street 1:1732 CANDLER LN
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-8214
Practice Address - Country:US
Practice Address - Phone:209-606-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27915225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist