Individual
MIRANDA GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12039 ALTA CARMEL CT UNIT 132, SAN DIEGO, CA 92128-3818
(708) 205-3370
Mailing address
12039 ALTA CARMEL CT UNIT 132, SAN DIEGO, CA 92128-3818
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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