Healthcare Provider Details
I. General information
NPI: 1700799269
Provider Name (Legal Business Name): MS. ABIGAIL MARTINA GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2806 W SAN GABRIEL AVE
FRESNO CA
93705-1143
US
IV. Provider business mailing address
2806 W SAN GABRIEL AVE
FRESNO CA
93705-1143
US
V. Phone/Fax
- Phone: 559-320-7176
- Fax:
- Phone: 559-320-7176
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: