Individual
JOHN GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3281 LEDGEWOOD CIRCLE, RIVERSIDE, CA 92503
(909) 702-5413
Mailing address
3281 LEDGEWOOD CIRCLE, RIVERSIDE, CA 92503
(909) 702-5413
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
833543
CA
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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