Provider Demographics
NPI:1023737848
Name:GUTIERREZ, LUCIA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DESI
Other - Middle Name:
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:18507 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-3826
Mailing Address - Country:US
Mailing Address - Phone:813-361-3603
Mailing Address - Fax:
Practice Address - Street 1:2330 POST ST STE 500
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3495
Practice Address - Country:US
Practice Address - Phone:415-885-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist