Provider Demographics
NPI:1598891087
Name:GUTIERREZ, LILIANA (MA)
Entity Type:Individual
Prefix:MS
First Name:LILIANA
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 FARNEL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-4960
Mailing Address - Country:US
Mailing Address - Phone:805-922-0334
Mailing Address - Fax:805-922-6543
Practice Address - Street 1:402 FARNEL RD
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4960
Practice Address - Country:US
Practice Address - Phone:805-922-0334
Practice Address - Fax:805-922-6543
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool