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NPI Code Detail

MEDICARE: AMELIA FAITH GUTIERREZ

MEDICARE: AMELIA FAITH 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
1103TS0200XSchool Psychologist220286921CA

General Provider Information

NPI Number : 1598640674
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA FAITH GUTIERREZ
Provider Business Mailing Address
First Line : 277 LOS ALTOS WALK
Second Line :
City : VENTURA
State : CA
Zip : 93004-2902
Country : US
Telephone Number : 805-258-8938
Fax Number :
Provider Business Practice Location Address
First Line : 5297 MAUREEN LN
Second Line :
City : MOORPARK
State : CA
Zip : 93021-7125
Country : US
Telephone Number : 805-378-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2025
Last Update Date : 08/08/2025

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Directions to “ AMELIA FAITH GUTIERREZ ” Practice Location

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