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NPI Code Detail

MEDICARE: CRYSTAL GUTIERREZ

MEDICARE: CRYSTAL 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
1390200000XStudent in an Organized Health Care Education/Training Program
2104100000XSocial WorkerACSW138391CA
3373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1265314926
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL GUTIERREZ
Provider Business Mailing Address
First Line : 801 EMPIRE ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5702
Country : US
Telephone Number : 707-425-5744
Fax Number : 707-425-5162
Provider Business Practice Location Address
First Line : 801 EMPIRE ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5702
Country : US
Telephone Number : 707-425-5744
Fax Number : 707-425-5162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2025
Last Update Date : 06/01/2026

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Directions to “ CRYSTAL GUTIERREZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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