Healthcare Provider Details

I. General information

NPI: 1518890334
Provider Name (Legal Business Name): MONICA GUTIERREZ RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27365 JEFFERSON AVE STE L-M
TEMECULA CA
92590-5692
US

IV. Provider business mailing address

3494 YELLOWSTONE CT
PERRIS CA
92570-5561
US

V. Phone/Fax

Practice location:
  • Phone: 951-719-1199
  • Fax: 951-719-1128
Mailing address:
  • Phone: 951-719-1199
  • Fax: 951-719-1128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDH26915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: