Jennifer Gutierrez

Individual provider Active NPI Professional Counselor · Modesto, CA

NPI 1013780717 · NPPES record last updated Jan 16, 2024

Key facts

NPI
1013780717
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
119661 (CA)
Practice address
1620 Cummins Dr
Modesto, CA 95358-6400
Phone
(209) 576-1750
NPI assigned
Nov 3, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 119661 CA Yes

Addresses

Primary practice location

1620 Cummins Dr
Modesto, CA 95358-6400

Mailing address

1620 Cummins Dr
Modesto, CA 95358-6400
Phone (209) 576-1750

Other providers in Modesto, CA

All providers in Modesto, CA · Professional Counselor in California

Sources for this page

Verify at the official NPI Registry.