Individual
JOEY TEDDY GUTIERREZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
4411 E KINGS CANYON RD # 319, FRESNO, CA 93702-3604
(559) 600-2382
Mailing address
3433 W SHAW AVE STE 102, FRESNO, CA 93711-3229
(559) 558-4051
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
697689
CA
Other
Enumeration date
05/29/2018
Last updated
03/30/2022
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