Healthcare Provider Details

I. General information

NPI: 1184857971
Provider Name (Legal Business Name): MS. VANESSA GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N LOCUST ST 220 N. LOCUST
VISALIA CA
93291-4946
US

IV. Provider business mailing address

704 S EDWARDS CT
VISALIA CA
93277-2217
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-1385
  • Fax: 559-636-2105
Mailing address:
  • Phone: 559-623-5408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: