Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1043531692 |
---|---|
Provider Name | Fabiola Margarita Gutierrez |
First Address | Santa Maria, CA 93454-7274 |
Second Address | Santa Maria, CA 93455-3620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 08/09/2014 |