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General NPI Number Information
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NPI Number | 1255600805
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Entity Type | Individual
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Provider Name | ISAAC ABRAHAM GUTIERREZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 2101 ALEXIAN DR STE 110
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City | SAN JOSE
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State | CA
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Zip | 95116-1901
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Country | US
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Telephone | 408-278-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 819 BIRCH AVE
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City | SUNNYVALE
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State | CA
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Zip | 94086-5138
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Country | US
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Telephone | 669-600-9577
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20242
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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 | 88948
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License Number State | CA
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