Abby Gutierrez Diaz
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fowler, CA
NPI 1497477707 · NPPES record last updated Oct 29, 2024
Key facts
- NPI
- 1497477707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- SUDRC19711 (CA)
- Practice address
- 311 E Merced St
Fowler, CA 93625-2316 - Phone
- (559) 892-9452
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SUDRC19711 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prodigy Healthcare Non Profit | Current |
Accepting new patients | |
| Prodigy Healthcare Inc. | Addiction (Substance Use Disorder) | Past |
Accepting new patients |
Locations
311 E Merced St
Fowler, CA 93625
Phone (555) 892-9452
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | SUDRC19711 | CA | Yes |
Addresses
Primary practice location
311 E Merced St
Fowler, CA 93625-2316
Mailing address
311 E Merced St
Fowler, CA 93625-2316
Phone (559) 892-9452
Other providers in Fowler, CA
- Melissa Giron Miranda
- Heidi Guzman Gomez
- Jessica Gomez
- Roseann Francis Gomez
- Steven Gong
- Baylee Gutierrez
- Jennifer Guzman
- Harry Chen, M.D., Inc., a Professional Corporation
- Vikram Hayer
- Kijzanae Hempstead
All providers in Fowler, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.