Healthcare Provider Details

I. General information

NPI: 1407792377
Provider Name (Legal Business Name): MONICA GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6855 BUTTE DR
RIVERSIDE CA
92505-1005
US

IV. Provider business mailing address

6855 BUTTE DR
RIVERSIDE CA
92505-1005
US

V. Phone/Fax

Practice location:
  • Phone: 951-283-4926
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number101305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: