MEDICARE: LUCIA GUTIERREZ MA, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1023737848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCIA GUTIERREZ MA, CCC-SLP

Provider Business Mailing Address
First Line	:	18507 LAKESHORE DR
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33549-3826
Country	:	US
Telephone Number	:	813-361-3603
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 POST ST STE 500
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3495
Country	:	US
Telephone Number	:	415-885-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	08/24/2022

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Directions to “ LUCIA GUTIERREZ MA, CCC-SLP” Practice Location

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