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General NPI Number Information
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NPI Number | 1043966401
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Entity Type | Individual
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Provider Name | GUADALUPE BUITRON
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Gender | Female
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 7891 MISSION GROVE PKWY S STE B
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City | RIVERSIDE
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State | CA
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Zip | 92508-6004
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Country | US
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Telephone | 951-776-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 6296 MAGNOLIA AVE # 1061
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City | RIVERSIDE
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State | CA
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Zip | 92506-2526
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Country | US
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Telephone | 951-241-1132
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 121510
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License Number State | CA
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