Provider Demographics
NPI:1316271349
Name:GUTIERREZ, JULIE LOUISE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LOUISE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 DUBOIS AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-2547
Mailing Address - Country:US
Mailing Address - Phone:916-289-1581
Mailing Address - Fax:916-925-0137
Practice Address - Street 1:362 DUBOIS AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2547
Practice Address - Country:US
Practice Address - Phone:916-289-1581
Practice Address - Fax:916-925-0137
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA159912253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care