Healthcare Provider Details

I. General information

NPI: 1881261378
Provider Name (Legal Business Name): DAN GUTTERMAN PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E COLORADO BLVD STE 425
PASADENA CA
91105-3729
US

IV. Provider business mailing address

117 E COLORADO BLVD STE 425
PASADENA CA
91105-3729
US

V. Phone/Fax

Practice location:
  • Phone: 323-456-3870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: