Healthcare Provider Details

I. General information

NPI: 1225155377
Provider Name (Legal Business Name): ADRIANA GUTIERREZ MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 COLIMA RD
WHITTIER CA
90603
US

IV. Provider business mailing address

10155 COLIMA RD
WHITTIER CA
90603-2042
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-0383
  • Fax: 562-692-0380
Mailing address:
  • Phone: 562-692-0383
  • Fax: 562-692-0380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number65948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: