Provider Demographics
NPI:1447146964
Name:GUTIERREZ, GIOVANNA EDITH
Entity type:Individual
Prefix:MRS
First Name:GIOVANNA
Middle Name:EDITH
Last Name:GUTIERREZ
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 1:116 LUPINE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-4320
Mailing Address - Country:US
Mailing Address - Phone:562-916-6674
Mailing Address - Fax:
Practice Address - Street 1:21250 BOX SPRINGS RD STE 212
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-8712
Practice Address - Country:US
Practice Address - Phone:951-686-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker