Healthcare Provider Details

I. General information

NPI: 1346190832
Provider Name (Legal Business Name): JOSEPHINE GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOSPITAL DR
VALLEJO CA
94589-2594
US

IV. Provider business mailing address

5243 VENETIAN DR
FAIRFIELD CA
94534-6667
US

V. Phone/Fax

Practice location:
  • Phone: 707-554-4444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: