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NPI Code Detail

MEDICARE: ROBERTA GUTIERREZ LVN

MEDICARE: ROBERTA GUTIERREZ LVN
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
1164X00000XLicensed Vocational Nurse180361CA

General Provider Information

NPI Number : 1952890428
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTA GUTIERREZ LVN
Provider Business Mailing Address
First Line : 3933 HARRISON ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3523
Country : US
Telephone Number : 951-358-5751
Fax Number :
Provider Business Practice Location Address
First Line : 3933 HARRISON ST
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-3523
Country : US
Telephone Number : 951-358-5751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2018
Last Update Date : 01/27/2024

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Directions to “ ROBERTA GUTIERREZ LVN” Practice Location

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