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NPI Code Detail

MEDICARE: PAUL GUTIERREZ

MEDICARE: PAUL 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1154287043
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL GUTIERREZ
Provider Business Mailing Address
First Line : 3625 CITADEL DR S
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5320
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 N SANTA FE AVE
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1738
Country : US
Telephone Number : 719-347-8201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ PAUL GUTIERREZ ” Practice Location

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