Healthcare Provider Details

I. General information

NPI: 1467960591
Provider Name (Legal Business Name): ERIKA LIZETTE GUTIERREZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13333 PALMDALE RD
VICTORVILLE CA
92392-9364
US

IV. Provider business mailing address

13333 PALMDALE RD
VICTORVILLE CA
92392-9364
US

V. Phone/Fax

Practice location:
  • Phone: 760-487-3600
  • Fax:
Mailing address:
  • Phone: 607-487-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: