Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043827504 |
---|---|
Provider Name | Cindy Gutierrez |
First Address | San Leandro, CA 94577-4962 |
Second Address | San Leandro, CA 94577-4962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2020 |
Last Update Date | 22/02/2021 |