Provider Demographics
NPI:1780063826
Name:GUTIERREZ, LORI L (MSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11976 CULVER BLVD
Mailing Address - Street 2:C/O DEL REY SQUARE SENIOR HOUSING
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-7441
Mailing Address - Country:US
Mailing Address - Phone:310-390-1122
Mailing Address - Fax:
Practice Address - Street 1:11976 CULVER BLVD
Practice Address - Street 2:C/O DEL REY SQUARE SENIOR HOUSING
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-7441
Practice Address - Country:US
Practice Address - Phone:310-390-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker