Provider Demographics
NPI:1851643282
Name:GUTIERREZ, RUBEN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27305 LIVE OAK RD STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91384-4520
Mailing Address - Country:US
Mailing Address - Phone:661-310-1525
Mailing Address - Fax:310-398-5690
Practice Address - Street 1:27201 TOURNEY RD STE 201K
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1804
Practice Address - Country:US
Practice Address - Phone:661-310-1525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT96985106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist