Provider Demographics
NPI:1962561175
Name:GUTIERREZ WOOLRIDGE, LAURA LINDA (LCSW LCS 25679)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LINDA
Last Name:GUTIERREZ WOOLRIDGE
Suffix:
Gender:F
Credentials:LCSW LCS 25679
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LINDA
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 S HILL RD
Mailing Address - Street 2:STE 100
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4455
Mailing Address - Country:US
Mailing Address - Phone:805-485-6114
Mailing Address - Fax:
Practice Address - Street 1:4001 MISSION OAKS BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5121
Practice Address - Country:US
Practice Address - Phone:805-485-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 256791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical