Provider Demographics
NPI:1245967561
Name:GUTIERREZ, NAYELI SANDYBEL (MSW, ASCW)
Entity type:Individual
Prefix:
First Name:NAYELI
Middle Name:SANDYBEL
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MSW, ASCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 GOLDEN AVE APT 426
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2167
Mailing Address - Country:US
Mailing Address - Phone:323-892-9665
Mailing Address - Fax:
Practice Address - Street 1:5800 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-4016
Practice Address - Country:US
Practice Address - Phone:323-308-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW902311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical