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NPI Code Detail

MEDICARE: MAYRA GUTIERREZ

MEDICARE: MAYRA GUTIERREZ
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
1104100000XSocial WorkerASW131557CA

General Provider Information

NPI Number : 1063899730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYRA GUTIERREZ
Provider Business Mailing Address
First Line : 18221 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-2676
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18221 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-2676
Country : US
Telephone Number : 714-730-0930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2015
Last Update Date : 07/21/2025

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Directions to “ MAYRA GUTIERREZ ” Practice Location

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