Healthcare Provider Details

I. General information

NPI: 1780192732
Provider Name (Legal Business Name): GLORIA GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 CAL CENTER DR STE 340
SACRAMENTO CA
95826-3225
US

IV. Provider business mailing address

131B STONY CIRCLE, SUITE 1200
SANTA ROSA CA
95401
US

V. Phone/Fax

Practice location:
  • Phone: 916-254-5200
  • Fax:
Mailing address:
  • Phone: 707-576-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: