Provider Demographics
NPI:1265286611
Name:GUTIERREZ, CECILIA GATCHALIAN (MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:GATCHALIAN
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:MS
Other - First Name:CECILIA
Other - Middle Name:BUENO
Other - Last Name:GATCHALIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 S WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-6934
Mailing Address - Country:US
Mailing Address - Phone:909-820-8150
Mailing Address - Fax:
Practice Address - Street 1:815 S WILLOW AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-6934
Practice Address - Country:US
Practice Address - Phone:909-820-8150
Practice Address - Fax:909-820-8151
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557581163WC1500X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health