Healthcare Provider Details

I. General information

NPI: 1033065883
Provider Name (Legal Business Name): STEPHANIE GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N F ST
OXNARD CA
93030-4003
US

IV. Provider business mailing address

1051 S A ST
OXNARD CA
93030-7442
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-1527
  • Fax:
Mailing address:
  • Phone: 805-385-1501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: