Provider Demographics
NPI:1669830022
Name:GUTIERREZ, BOBBI COLETTE KYLE (MFT TRAINEE)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:COLETTE KYLE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MFT TRAINEE
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:C
Other - Last Name:KYLE HAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:950 W JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2226 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2007
Practice Address - Country:US
Practice Address - Phone:408-560-8597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)