Provider Demographics
NPI:1831576289
Name:GUTIERREZ, CLAUDIA PATRICIA (MS)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:PATRICIA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:PATRICIA
Other - Last Name:MARCIAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5225 CANYON CREST DR BLDG 100
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6301
Mailing Address - Country:US
Mailing Address - Phone:951-248-4000
Mailing Address - Fax:
Practice Address - Street 1:5225 CANYON CREST DR BLDG 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6301
Practice Address - Country:US
Practice Address - Phone:951-248-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT124159106H00000X
CAIMF88266106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist