Individual
MISS EVANGELINA GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
66 HURLBUT ST, PASADENA, CA 91105-4025
(626) 441-4221
(626) 799-1246
Mailing address
2219 MOUNTAIN AVE, DUARTE, CA 91010
(626) 827-3833
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 36097
CA
Other
Enumeration date
08/23/2011
Last updated
08/23/2011
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