Provider Demographics
NPI:1962116426
Name:CORTEZ, PRINCESS DIONE GUTIERREZ (PMHNP)
Entity type:Individual
Prefix:
First Name:PRINCESS DIONE
Middle Name:GUTIERREZ
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 GARDEN GROVE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-8201
Mailing Address - Country:US
Mailing Address - Phone:562-431-8822
Mailing Address - Fax:562-431-8875
Practice Address - Street 1:5455 GARDEN GROVE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-8201
Practice Address - Country:US
Practice Address - Phone:562-431-8822
Practice Address - Fax:562-431-8875
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA831705163WP0808X
CA95027392363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health