=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467307538
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUANITA V GUTIERREZ SUDCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 S FAIRFAX RD
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93307-8520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-366-1800
-----------------------------------------------------
Fax | 661-363-6475
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5801 SUNDALE AVE
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-7908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-827-3100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 9329
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------