Provider Demographics
NPI:1255158465
Name:GUTIERREZ MARTINEZ, BELLA
Entity type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:GUTIERREZ MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32809 TANNAT DR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-0379
Mailing Address - Country:US
Mailing Address - Phone:951-265-1362
Mailing Address - Fax:
Practice Address - Street 1:1105 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4512
Practice Address - Country:US
Practice Address - Phone:951-265-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor