Healthcare Provider Details

I. General information

NPI: 1295159747
Provider Name (Legal Business Name): JOSEPH ATTEBERRY GUTIEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 03/10/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HARBOR BLVD
BELMONT CA
94002-4047
US

IV. Provider business mailing address

862 CORTEZ LN
FOSTER CITY CA
94404-2953
US

V. Phone/Fax

Practice location:
  • Phone: 650-599-9955
  • Fax:
Mailing address:
  • Phone: 415-254-6430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number109472
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number133632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: