Provider Demographics
NPI:1720866734
Name:GUTIERREZ, ERICA LOUISE (SUDRC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LOUISE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:SUDRC
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:LOUISE
Other - Last Name:STROPPINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUDRC
Mailing Address - Street 1:20271 SW BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1752
Mailing Address - Country:US
Mailing Address - Phone:888-629-6707
Mailing Address - Fax:
Practice Address - Street 1:8086 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-5941
Practice Address - Country:US
Practice Address - Phone:888-629-6707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11966101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)