Individual
MARLENE GUADALUPE GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
13330 VAUGHN ST, SAN FERNANDO, CA 91340-2216
(818) 896-7461
Mailing address
13330 VAUGHN ST, SAN FERNANDO, CA 91340-2216
(818) 896-7461
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
LCSW121473
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
11/27/2020
Last updated
09/18/2025
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