Provider Demographics
NPI:1164383303
Name:GUTIERREZ, JUANITA FELISITA
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:FELISITA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15990 MARIETTA LN
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-9673
Mailing Address - Country:US
Mailing Address - Phone:530-727-4328
Mailing Address - Fax:
Practice Address - Street 1:15990 MARIETTA LN
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-9673
Practice Address - Country:US
Practice Address - Phone:530-727-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB4226368374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula