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NPI Code Detail

MEDICARE: EMILSA RAQUEL GUTIERREZ

MEDICARE: EMILSA RAQUEL GUTIERREZ
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
1101YP2500XProfessional Counselor15900CA

General Provider Information

NPI Number : 1699613034
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILSA RAQUEL GUTIERREZ
Provider Business Mailing Address
First Line : 867 N FAIR OAKS AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-3050
Country : US
Telephone Number : 626-797-6793
Fax Number :
Provider Business Practice Location Address
First Line : 867 N FAIR OAKS AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-3050
Country : US
Telephone Number : 626-797-6793
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ EMILSA RAQUEL GUTIERREZ ” Practice Location

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