Provider Demographics
NPI:1962047134
Name:GUTIERREZ, DANIELLE MARCIA
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MARCIA
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 1:1731 HOWE AVE STE 585
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2209
Mailing Address - Country:US
Mailing Address - Phone:916-359-2950
Mailing Address - Fax:
Practice Address - Street 1:1610 EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-2608
Practice Address - Country:US
Practice Address - Phone:916-359-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician