Provider Demographics
NPI:1821114240
Name:GUTIERREZ, ELIZABETH MOLINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MOLINA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SHOW CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-4532
Mailing Address - Country:US
Mailing Address - Phone:626-862-0951
Mailing Address - Fax:
Practice Address - Street 1:1600 SHOW CT
Practice Address - Street 2:
Practice Address - City:S EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-4532
Practice Address - Country:US
Practice Address - Phone:626-862-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health