MEDICARE: VALERIE GUTIERREZ-POQUIZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	108171	CA

General Provider Information

NPI Number	:	1134877897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE GUTIERREZ-POQUIZ DDS

Provider Business Mailing Address
First Line	:	877 SANDY COVE DR
Second Line	:
City	:	RODEO
State	:	CA
Zip	:	94572-2020
Country	:	US
Telephone Number	:	510-685-3242
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 KAINS AVE
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-1217
Country	:	US
Telephone Number	:	510-524-6045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2022
Last Update Date	:	04/15/2026

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