Provider Demographics
NPI:1831825512
Name:GUTIERREZZ, SOFIA YVETTE
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:YVETTE
Last Name:GUTIERREZZ
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 1:1488 LA SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9100
Mailing Address - Country:US
Mailing Address - Phone:415-756-4957
Mailing Address - Fax:
Practice Address - Street 1:1488 LA SIERRA ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-9100
Practice Address - Country:US
Practice Address - Phone:415-756-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator