Provider Demographics
NPI:1720866734
Name:GUTIERREZ, ERICA LOUISE
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LOUISE
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:LOUISE
Other - Last Name:STROPPINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUDRC
Mailing Address - Street 1:1400 X ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-2200
Mailing Address - Country:US
Mailing Address - Phone:279-786-1428
Mailing Address - Fax:
Practice Address - Street 1:1400 X ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2200
Practice Address - Country:US
Practice Address - Phone:279-789-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11966101YA0400X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)